Assessment of WIC Cost-Containment Practices: Final Report

by John A. Kirlin, Nancy Cole, and Christopher Logan

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides both nutrition education and supplemental foods for pregnant, breastfeeding, and post-partum women, infants, and children. These supplemental foods contain nutrients that nutritional research has found may otherwise be lacking in the diets of WIC recipients. State WIC agencies have implemented practices designed to reduce the cost of food packages containing these prescribed foods. For instance, one of the WIC program's primary cost-saving practices is negotiating rebate contracts with manufacturers of infant formula. Additional practices include limiting authorized vendors to stores with lower food prices; limiting approved brands, package sizes, forms, or prices; and negotiating rebates with food manufacturers or suppliers. There is concern that these practices may inadvertently counter the program's goal of providing supplemental foods and nutrition education. Based on a review of cost-containment practices in six States, including interviews with the various stakeholders and analysis of WIC administrative files, the study draws three major conclusions: (1) cost-containment practices reduced average food package costs by 0.2 to 21.4 percent, depending on practices implemented and local conditions; (2) the cost-containment practices had few adverse outcomes for WIC participants; and (3) administrative costs of the practices were low, averaging about 1.5 percent of food package savings.

Keywords: WIC program, cost-containment, food-item restrictions, vendor restrictions, manufacturers rebates, food package costs, Special Supplemental Nutrition Program for Women, Infants, and Children, child nutrition, FANRP, food assistance

In this publication...

• Entire Report
• Abstract, Acknowledgments, Summary, Contents
• Chapter I: Introduction
• Chapter 2: State Cost-Containment Practices and Their Administrative Costs
• Chapter 3: Approved Foods and Food Selection
• Chapter 4: Food Costs and Food Cost Savings
• Chapter 5: Access to WIC Vendors and Availability of Prescribed Foods
• Chapter 6: Participant Satisfaction With and Use of Prescribed Foods
• Chapter 7: WIC Participants with Special Diets or Food Allergies
• Chapter 8: Food Instrument Redemption
• Chapter 9: Program Participation
• Chapter 10: Health Outcomes
• Chapter 11: Summary and Conclusions
• Appendix A: Survey of WIC Participants
• Appendix B: Survey of Food Prices and Item Availability
• Appendix C: WIC Transaction Data
• Appendix D: Interviews with Stakeholders
• Appendix E: State Cost-Containment Practices
• Appendix F: Administrative Costs of Cost Containment
• Appendix G: Use of Food Price Information to Limit Payments to Vendors
• Appendix H: WIC Food Packages, as Defined in the Code of Federal Regulations (7 CFR 246.10)
• Appendix I: Participant Satisfaction with and Use of Prescribed Foods, Selected Food Categories
• Appendix J: Models of Participant Satisfaction With and Use of Prescribed Foods
• Appendix K: Models of Health Outcomes