This meal plan is paid for by medical insurance

Diets on demand.
Diets on demand.
Image: Reuters/Heinz-Peter Bader
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When Christina Bognet pitched the idea for a personalized meal-planning startup in 2012, she told potential investors that one day the company’s services would be covered by health insurers.

This year, Bognet and her company, PlateJoy, made good on that promise. PlateJoy in late February debuted a nutrition plan designed to prevent diabetes that is covered by five Blue Cross Blue Shield health insurance plans, plus employers Kroger, Dignity Health, and Express Scripts.

PlateJoy isn’t a “meal kit” in the sense of Blue Apron—it doesn’t ship you any food. Instead, PlateJoy maps out meals for its users, customizing recipes to dietary preferences (“low carb,” “gluten free,” “paleo”), lifestyle goals (“trying to lose weight”), and available cooking time and appliances. Customers can buy the groceries themselves, or pay extra to order everything through grocery-delivery service Instacart. Without the food itself, PlateJoy costs $14 a month or $69 for a six-month plan and $99 for a 12-month plan.

Customers who qualify for insurance coverage pay nothing out of pocket. They typically hear about the program from their employer or their insurer, and take a short quiz on PlateJoy’s website to see whether they qualify for diabetes prevention and thus insurance coverage. PlateJoy submits claims to insurers or employers when users of its pre-diabetes program hit specific health-related milestones, such as losing 5% of their starting body weight. “This is a pay-for-performance model that really prioritizes successful outcomes,” Bognet said.

Preventing diabetes isn’t the kind of sexy business you hear a lot about in Silicon Valley. The disease was the seventh leading cause of death in the US in 2015, according to the most recent data available from the Centers for Disease Control and Prevention (CDC). More than 84 million Americans, or one in three adults, have elevated levels of blood sugar that qualify as prediabetes. Research has found that “lifestyle intervention“—changes in diet and physical activity—can reduce by nearly 60% the likelihood of the condition progressing to full-blown type 2 diabetes, the version of the disease most common among US adults.

By focusing on diabetes and getting insurers to pay for the meal plans, PlateJoy may have hit upon a model that works. The company has raised $2.7 million to date, most of that from a $1.7 million round of seed funding in April 2015. Other meal-kit startups, once the darlings of Silicon Valley, have fallen out of favor.  Blue Apron, which had a $2 billion valuation as a startup, went public in June 2017 at $10 a share and has since lost 80% of its value, with shares currently trading a little under $2 each. Meal-kit startup Plated sold to grocery and pharmacy chain Albertsons in September.

“The meal-kit delivery companies are helping to make cooking at home more convenient, which is great, but they don’t address this basic reality that people have different tastes, nutritions, and schedules,” Bognet said. “When you talk to users, everyone says, ‘I’m very different, I’m an outlier.’ Everyone says that.”

PlateJoy’s diabetes prevention plan includes a Fitbit, wireless scale, and weekly video lessons with wellness experts, plus the company’s normal meal-planning service. PlateJoy started building it a year ago and had a couple hundred users test it in late 2017.

Marjie Starkey, 42, joined PlateJoy’s program in January. She had gestational diabetes during both her pregnancies and heard about the diabetes prevention plan from her insurer, Anthem Blue Cross. Starkey likes that she can customize the plan to her other goals and needs, like following a Ketogenic diet or using up the 20 pounds of boneless chicken breasts she purchased at Costco. Since signing up, she’s lost 15 pounds. “I have the data to show that I have been making improvements in my weight,” said Starkey, who lives in California.

Christopher Gardner, a professor of medicine and nutrition expert at Stanford University, said it’s “short-sighted” how little attention health care professionals pay to food. He said a lifestyle change program like PlateJoy’s makes a lot of sense, especially if it can convince patients and insurers to take steps now to prevent a disease that can take years to set in. “Insurance companies could save billions of dollars from claims from diabetes if we could address this food issue,” he said.

Weight Watchers also offers a prediabetes program that includes weekly “lifestyle meetings,” online chats with Weight Watchers staff, and digital tools to track weight loss and activity. The program cost varies and is covered by some insurers. Weight Watchers is registered with the CDC’s National Diabetes Prevention Program and has received “preliminary recognition” for its services, meaning it’s submitted at least 12 months of data on a set of users that stuck with the program for a year. PlateJoy’s status with the CDC is pending as it’s been around for less than a year. The CDC awards three statuses—pending, preliminary recognition, and full recognition—any of which allows companies to receive insurance reimbursement for their services.

Bognet became interested in nutrition and health while studying neuroscience as an undergraduate at Massachusetts Institute of Technology. She worked in health care consulting after college and had planned to go to medical school, until hearing from doctors that nutrition was just as important to patient health as medication. She focused on her own health and lost 50 pounds, weight that she has kept off.

She sees PlateJoy as part of a wellness trend in health care that also makes financial sense. Research estimates the lifetime average cost of treatment for a patient with diabetes in the US at more than $85,000. Bognet thinks PlateJoy aligns the interests of all parties: Patients get healthier for less money; insurers save money; and her company gets paid.

“Insurance companies know that it makes sense to pay for prevention instead of treatment,” she said. “I think five years from now, insurers will pay for your SoulCycle classes because they know it’s going to save them money long term.”