Tom Shicowich “really, really, really liked Coca-Cola” before he began a new nutrition program targeting his Type 2 diabetes and weight. Being on a “very tight budget,” he couldn’t afford the fruit and vegetables he cut up for a living at his part-time grocery store job. Dinner was often a pizza or fast food meal he picked up on the way home.

Six months after getting free healthy groceries every week through the Geisinger hospital near his rural Pennsylvania home, Shicowich has cut his blood sugar level from nearly 11 to close to a normal level of 7. The 6′ 5″ former high school track team competitor has lost 35 pounds but is still nearly 200 pounds from his target weight of 250 pounds.

“It is no coincidence that the health systems and hospitals that are doing it the best have aligned their incentives more closely to the health of their patients,” says Joshua Sharfstein, a pediatrician who is a former secretary of health for Maryland and top Food and Drug Administration official. “It’s very hard to ask a hospital that’s getting paid for every preventable admission to invest in ways that would eliminate those admissions.”

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