Section 6. Summary & Opportunities

Summary

Exploring the Benefits was a small-scale research project that used qualitative methods to explore patient and food supplier perspectives about use of local food in FreshRx, a PPR program in New Mexico. While a small body of research has incorporated the use of qualitative methods, such as PhotoVoice, to examine participant experiences in PPR programs, limited work has used these methods to examine a clinic food bag distribution model (Center for Outcomes Research and Education , 2016; Riemer, 2019; Riemer et al, 2021). Additionally, very limited work has examined the local farmer perspective, and our study provides a unique contribution to the PPR evaluation literature by connecting the perspectives of the local farmer, food hubs, and patients (Shostak et al, 2025).

Patient Perspective Highlights:

• For FreshRx patients, those who participated in this project clearly valued the produce that was provided and experienced many benefits from the program.
• They were able to incorporate the produce into their family meals, and they appreciated the ability to access fresh, nutritious food from local farmers.
• The stories patients shared illustrate how the program allows patients to eat healthier by promoting home-cooked nutritious meals among patients in real need.
• Participants also noted that FreshRx benefits family members and neighbors through food sharing.
• Without the FreshRx program, the participants would not have been able to enjoy most of the produce included in the program, as many items in the food bags were not commonly found in local grocery stores, and the cost of such items at the farmers’ market was noted as being prohibitive for some patients.

Food Supplier Highlights:

• Local food supply chain actors reported being closely linked to each other and dependent upon one another.
• These actors also feel a connection to the communities and populations where their food is going.
• T here are economic and social values to these linkages/relationships, contributing to what appears to be a strong, resilient, and connected network. Farmers and food hubs alike are vital contributors to this network, each having their roles and being necessary to the functioning of the current system.

The supply chains presented in this research (and the farmers, food hubs, and CBOs that comprise them) are good examples that fit within the supply chain responsibility and SFSC framework literature, as they are not simply focused on profit-making activities, but rather have connections to community, place, land, and people that motivate their work and their priorities. Interviewees revealed that their ‘place identity’ is inspiring them to consider motivations beyond profits (Zhao et al, 2025) that are more socially and community-oriented. Furthermore, as is noted in recent literature on food system resiliency ( High Level Panel of Experts , 2025), part of what is needed to create "equitably transformative resilience" is to move beyond value chain/supply chain thinking to a wider vision that incorporates the necessity of community control over food systems (Anderson et al, 2026), similar to what has been demonstrated in this study.

It is important to also note that these local FSCs are in many ways completely different supply chains than the industrial/ non-local food system, and it remains difficult to compare them in terms of scale/ volume/ price/ etc. The local FSCs cannot and should not simply replace the non-local; however, local food can take on an increasingly larger proportion of food being provided to communities and can help especially in reaching remote communities. For example, one of the suppliers noted that “ a big part of what we do is help maintain distribution routes throughout the state that are not financially beneficial for a for-profit company to do, because it's hard to make money on distribution. So we help maintain a route north to south, working with partners and food hubs throughout the state, farmers throughout the state, to help move products up and down and even continue on to kind of the northeast and northwest portions of the state.”

As New Mexico continues to work towards more resilient, community-driven, and equitable food systems, this report highlights the benefits of supporting expanded rural delivery routes, engaging in deep community partnerships, and continuing to examine how to fill other infrastructure gaps.

Looking Ahead - Opportunities for the Future

Based on the findings from this study, several opportunities for the future have emerged:

• Policymakers and funders have an opportunity to: i) expand longer-term funding for PPR, institutional procurement, and other programs that stimulate demand for local food, as food recipients respond positively to fresh produce coming from local farms ; ii) emphasize local food in Medicaid Section 1115 waivers for PPR and other Food is Medicine services; and iii) invest in infrastructure to address major local supply chain gaps - such as lack of aggregation and storage facilities in Northern NM -  and to help farmers and food hubs better meet their production, aggregation, storage, and distribution needs.

• Healthcare providers (such as Medicaid organizations and private health plan providers) have an opportunity to incorporate more local food into their Food is Medicine initiatives , processes, and funding allocations, based on the importance of local supply chains in helping provide strong pathways to Food is Medicine approaches via the ability and abundance of cultural foods through local sources . Providers should explore partnerships with local CBOs, as they can play facilitating and other coordinating and connecting roles in this process so that providers do not have to start from scratch. CBOs have been shown to be critical facilitators in connecting local food system actors and ensuring food gets from farms to patients.

• CBOs managing PPR programs should seek expansion of long-term funding for locally sourced foods , be responsive to patient suggestions and requests (e.g., including recipes and food supplier information in the food bags, etc.), and continue playing a facilitating role in these types of programs , especially helping to support healthcare providers that may be interested in local sourcing but need CBO support to help get them started and begin to take the steps required for using local food. CBOs can be good partners to healthcare providers .

• Food hubs should work to expand the number of producers they are sourcing from, enhance their infrastructure capacities, improve overall efficiencies, and continue to offer important services to producers and collaborate with other hubs.

• Farmers should continue to seek market diversification, local sales outlets, connecting with hubs, and expanding operations and production as opportunities allow.

• Researchers and evaluators have an opportunity to : i) seek deeper understanding of local food supplier perspectives, motivations, capacities, and challenges related to participating in PPR programs; and ii) expand the use of qualitative approaches such as Photovoice to highlight participant voices and gain more nuanced understandings of participant experiences with local food in PPR and other similar programs.

Conclusion

In 2025, the NMFMA led a qualitative research project working in partnership with FreshRx patients and food suppliers to explore the benefits of using local produce in FreshRx, a PPR program. Patients valued the produce as they were able to incorporate it into their family meals, and they appreciated the ability to access fresh food from local farmers. Suppliers expressed close alignment with program goals such as improving food access and highlighted a connection to the communities and populations where their food is going. Suppliers also emphasized the importance of collaboration, relationships, community, and resilience within local food systems work.

The experiences and voices of the patients and suppliers portrayed in this study offer a powerful lens for gaining a deeper understanding of the FreshRx program and broader local food systems in New Mexico. Findings from this study will also be relevant in other settings, especially those in sparsely populated rural geographies with high rates of poverty and food insecurity and where local food sourcing is possible. Local food sourcing has been and should continue to be an important part of PPR and other Food is Medicine initiatives as it provides market outlets for local producers, strengthens community, and can reach populations that are more difficult to access.

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