HHS is asking the nation’s hospitals to serve healthier food and directed them this spring to align their menus with new federal nutrition guidelines. But a new CMS response obtained by Becker’s suggests the pressure may be more voluntary than it first appeared.
Geopolitical conflicts, including the war in Iran, and rising energy costs are disrupting the global food supply chain, according to a May 8 report from the Food and Agricultural Organization. The FAO Food Index, which tracks monthly changes in global food prices, reported a 2% year-over-year increase in food prices.
For the U.S., food prices have increased 3.3% over the last year, according to the U.S. Department of Agriculture. The USDA forecasts a 2.9% increase for all food in 2026.
These rising food prices could force hospitals into financial trade-offs. This spring, HHS directed hospitals to align their menus with new nutrition guidelines as compliance expectations appeared to harden — though the extent of that enforcement, it turns out, is contested.
A hallmark of the “Make America Healthy Again” movement is an emphasis on protein, dairy, healthy fats, fruits and vegetables. Many of those food groups are rising in price: Between April 2025 and April 2026, the FAO found a 6.4% increase in meat prices — a record high. Vegetable oil is at its highest level since July 2022.
Dairy is a notable exception, coming in 21.2% lower than April 2025 prices — a potential cost relief for hospitals that lean into dairy-forward menu options under the new guidelines.
Food as a clinical tool
Several health systems and hospitals are part of the “food is medicine” movement, with some growing their own food like Livonia, Mich.-based Trinity Health; operating a “food farmacy” that provides patients and families with nutrition meals, such as Danville, Pa.-based Geisinger; or investing millions of dollars in food and nutrition interventions in care models, like Oakland, Calif.-based Kaiser Permanente.
Pamela Schwartz, executive director for community health at Kaiser Permanente, told Becker’s the system’s scale gives it an advantage smaller hospitals often do not have.
“We have systemwide food standards for the foods we purchase, which are informed by clinicians, dietitians, operators and national dietary guidelines,” said Ms. Schwartz, who leads Kaiser’s “food is medicine” work. “These requirements are built into [requests for proposal] and vendor contracts from the start. Our scale allows us to set expectations that smaller hospital systems often cannot, and we have the resources to monitor compliance and drive accountability among our suppliers.”
Smaller systems and hospitals might struggle to meet HHS’ expectations — though how firm those expectations actually are is now less clear.
Allison Hess, vice president of population health and quality for Geisinger, said food access is increasingly being treated as a clinical tool, not just a social service.
“Consistent access to healthy food can improve key health markers, showing that food can function as a clinical intervention, not just a social support,” Ms. Hess said. “Integrating nutrition into care models also helps reduce avoidable utilization, such as emergency department visits, by supporting better disease management and prevention.”
What CMS said
The pressure on hospitals appeared to have an unusually sharp enforcement edge. On April 1, Calley Means, a top adviser to HHS Secretary Robert F. Kennedy Jr., posted on X: “If a hospital is serving patients sugary drinks, they are out of compliance with government standards and are putting their reimbursements in jeopardy. If you see patients being served sugary drinks, please post information below or let CMS know.”
The post included a phone number typically used for medical billing complaints, directing the public to report hospitals directly to regulators.
In response to Becker’s, a CMS spokesperson said the agency’s March 30 guidance “does not establish new mandates, change Medicare Conditions of Participation or create any new penalties for hospitals,” and that “CMS has not withheld funding from any facility on the basis of this guidance,” adding that the guidance is voluntary.
The spokesperson also said, “references to external websites or hotlines are not connected to this guidance and do not reflect HHS or CMS policy.”
The federal timeline
- Jan. 7 — The Trump administration released an updated Dietary Guidelines for Americans 2025-2030, which emphasizes whole foods, protein and healthy fats; limiting ultra-processed foods and added sugars.
- March 5 — HHS and the Education Department announced 53 medical schools across 31 states will require 40 hours of nutrition education starting fall 2026. Physicians currently in the workforce do not have this amount of nutrition education, HHS said, meaning the workforce that is supposed to counsel patients on diet have not received much formal training to do so.
- March 30 — CMS directed hospitals to align menus with the new dietary guidelines. Miami-based Nicklaus Children’s became the first hospital to sign HHS’ nutrition pledge, committing to a farm-to-hospital sourcing model.
- April 1 — Calley Means posted on X urging the public to report hospitals serving sugary drinks to a CMS hotline typically used for medical billing complaints. CMS later told Becker’s the post “does not reflect HHS or CMS policy.”
- April 13 — A brief from law firm Akin Gump Strauss Hauer & Feld noted that CMS has never before interpreted Conditions of Participation as mandating adherence to specific dietary guidelines, and did so here without new rulemaking.
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