Designing an effective FIM program is only the first step. Once an organization has defined its target population, selected intervention types, and clarified intended outcomes, the next—and often more consequential—question emerges: how should this work be operationalized?

Across health systems and health plans, FIM programs are implemented through a range of operating models. Some organizations choose to build capabilities in-house, embedding food delivery and nutrition support directly into care delivery. Others contract with external vendors to deliver FIM services at scale. Many pursue hybrid approaches that combine internal infrastructure with external partnerships.

These decisions shape more than logistics. An organization’s operating model affects speed to launch, cost structure, scalability, data integration, patient experience, and long-term sustainability. Importantly, there is no single best model.

Using case studies, we can assess the differences in approaches to operationalizing FIM in health care. The first illustrates a build model at a health care system, where FIM is tightly integrated into clinical care and community engagement. The organization accepts inherent operational complexity in exchange for more control and the ability to flexibly customize the program. The second illustrates a buy model at a health plan, where FIM is delivered through external partnerships that emphasize speed, scale, and financial alignment.