Healthcare of the future will have a newfound reliance on patient engagement – offsetting wellness accountability to the individual through self-care management initiatives and benefit/reimbursement incentives. Thus, this clinician model has and will be adapting roles from sole practitioner to educator - providing patients with tools and resources for improving health status, while also relinquishing some physician liability imposed by ACO and Healthcare regulations.

One of the many core initiatives PEA is deploying at health systems across the United States has its founding principles lead by Senator Harkin (D-Iowa) and a bi-partisan group of leaders at local, state and federal levels who have enacted legislation which places nutritional care on the same level as medication in the treatment of chronic illness and provides significant funding alternatives or incentives to reimbursement for treating the disease. The challenge was to develop systems that could be implemented within the healthcare continuum that synchronize the management of nutrition and medication at the point of transition from community-care to a hospital (avoiding the need for an acute complication of the disease) or more effectively send the patient home with the same standard of care and medication and nutrition coordination that is provided in the hospital on a patient by patient basis.

In addition, the health care legislation passed by Congress and signed into law by President Obama placed great emphasis on programs that support the implementation of local and federal programs to improve public access to nutritional foods and guidance. Section 3025 of H.R. 3590 specifies the need to curb excess hospital readmissions through the Hospital Readmission Reduction Program. Additionally, Section 4301 requires the Secretary of Health and Human Services, acting through the CDC, to provide funding for research in support of public health services and systems. Research supported under this section must include a comparison of community-based public health interventions in terms of effectiveness and cost as well as the identification of effective strategies for the organization, finance, and delivery of public health services in "real world community settings."

Changes in U.S. healthcare policy have reached a point where hospital systems have a need for a "take-out" version of the clinical diets that were formerly only provided during extended length of hospital stays or through the use of convalescent institutions. Community networks did not have the capacity to replicate these care-giving requirements without assistance. MedAssets and Homeplate developed a comprehensive supply-chain portfolio and developed product solutions that support an integrated discharge program connecting the formal care provided by acute care hospitals with the informal community networks already in place.

PEA's Medical Nutrition Therapy model extends the standard of care model that would have been provided in a convalescent institution or long-term care facility, including: (1) the provision of meals and coordinated medication compliance and adherence; (2) the provision of three daily meals that meet personal nutrition standards and nutritional supplements prescribed by their physician; (3) the establishment of a dietary care plan prescribed by the physician at the time of discharge and coordinated with the patient's primary care physician and home health professional; (4) the inclusion of monitoring and compliance tools that increase adherence to the prescribed dietary and medication plan and detect changes in condition; and (5) patient provision of seamless financial management services from reimbursed medical care to self-pay.