Powering Rural Health Transformation with Online Grocery Access
How online grocery delivery and nutrition incentives can unlock healthier choices in rural communities.
Every grocery cart has the potential to be a touchpoint in healthcare. This belief has guided our Instacart Health work from the beginning, because what we put on our tables shapes how we feel and how we manage our health every day. Increasingly, people also want their health plans and providers to recognize this reality: a recent study found that more than four in five Americans said healthcare should offer more food and nutrition programs to treat and manage illness.1
In rural communities, the basics that people need to support good health are often harder for them to reach. Rural residents are more likely to experience food insecurity and live farther from full-service grocery stores, while also facing higher rates of diet-related chronic conditions like diabetes and heart disease.2 When access to nutritious food isn’t reliable, managing those conditions day-to-day becomes that much harder.3
The Centers for Medicare & Medicaid Services (CMS) recently introduced the Rural Health Transformation (RHT) Program – a $50 billion, five-year investment to strengthen rural care, improve outcomes, and accelerate technology-driven solutions that advance prevention and chronic disease management. As states begin translating RHT into real programs, one of the most practical places to start is also one of the simplest: making nutritious food accessible, affordable, and actionable.
That's why today, we’re proud to announce that Instacart has joined the Collaborative for Healthy Rural America™ (CHRA) alongside Lumeris, Teladoc Health, Nuna, Deloitte, and Unite Us – a coalition committed to delivering comprehensive, technology-driven healthcare solutions for rural populations. Rural health transformation will take coordination across many partners, and Instacart is committed to being part of that effort. The infrastructure we've built, and the evidence behind it, is what makes this collaboration meaningful.
The infrastructure is already here.
Instacart connects people with the retailers they already know and trust, delivered in a way that fits into everyday routines. We partner with more than 2,200 retail banners and enable delivery from nearly 100,000 stores – reaching 98% of U.S. households, including 95% of households in low-income, low-access areas. More than 25 million customers rely on Instacart every year, with 68% considering Instacart an essential service.
What's just as important for these communities is the impact Instacart has on local economies. Since 2012, we've helped U.S. grocers generate more than $22.5 billion in additional revenue and create over 237,000 grocery jobs. Nearly one in three of those jobs was created at small, independent, community-rooted grocers – more than double the industry average rate of small business job creation. In total, Instacart has helped small grocers grow their revenue by $7 billion.4
We've also seen firsthand that simply making online grocery accessible can profoundly change how people eat and live – and even reduce costs for the systems that serve them. This showed in our work with TriMet, the public transit agency serving Portland, Oregon. TriMet provided Instacart+ memberships to eligible paratransit riders so they could have groceries and essentials delivered rather than rely solely on traditional paratransit trips to the store. Nearly 90% opted in, more than half of items ordered were fresh foods, and TriMet projected up to $4.5 million in annual savings if the model were adopted systemwide.5
When access meets guidance, outcomes improve.
Research conducted by the University of Kentucky and No Kid Hungry found that online grocery shopping helps low-income households, including those enrolled in SNAP, save time, reduce stress, and overcome transportation and mobility barriers. On average, online shoppers spent $5.24 more per week on fruits and vegetables than in-store shoppers – without increasing their total grocery bill. For participants who also received tailored support like shopping tips, meal planning suggestions, and incentives to offset fees, that figure rose to $6.84 per week, again without spending more overall.6 Participants were also more likely to plan meals when shopping online, helping them stretch their budgets further.
In 2024, Instacart and FoodSmart evaluated the impact of combining telenutrition with medically tailored grocery access among more than 18,500 participants living with diabetes and obesity. Those who used both saw meaningfully better results than those using telenutrition alone – 52.9% achieved a clinically significant A1c reduction versus 43.2%, the likelihood of 5% weight loss increased by nearly 50%, and engagement with nutrition coaching nearly doubled when grocery support was added.7
The evidence is clear: online grocery access isn't a nice-to-have addition to a care program; it's a multiplier. It deepens engagement, improves clinical outcomes, and has the potential to create savings.
Working together to improve rural health and a differentiated partnership with Teladoc.
We know this work can’t happen in isolation, and rural health transformation will take coordination across many partners. As a member of the CHRA, we’re working alongside many others to bring RHT to life for rural communities. The programs that scale share a few common traits: they're simple to launch, easy for people to use, and built to measure what's working. Making online grocery accessible strengthens local economies and helps families eat well. Pairing it with clinical incentives, nutrition guidance, and integrating it seamlessly with the right partners is how it can drive meaningful, sustained improvements in overall health.
That's exactly what our new partnership with Teladoc Health is designed to do. Last week, we announced an integration that connects Teladoc's cardiometabolic health programs directly to grocery access in two key ways.
First, eligible members enrolled in Teladoc's cardiometabolic health programs, which address chronic conditions like diabetes, hypertension, and obesity, can earn Instacart Health Fresh Funds by completing a program-specific device check – like a blood glucose reading, a blood pressure check, or a smart scale weigh-in – depending on their condition. These are dual-purpose rewards: they recognize a member for taking a meaningful step in their care, and they equip them with grocery access to keep supporting that progress. A member who completes a blood glucose check walks away with the means to stock up on foods that support their diabetes management. The incentive and the health behavior reinforce each other.
Second, Teladoc's library of curated recipes and nutrition content is now shoppable, powered by the Instacart Developer Platform (IDP). All Teledoc Health members can now browse a heart-healthy dinner recipe or a diabetes-friendly meal plan and easily add all the ingredients to their Instacart cart in seconds. This integration takes nutrition guidance from inspiration to action, making every visit to Teladoc's content library a step closer to a healthier meal at home.
Instacart is ready to work alongside states, health plans, and providers to help bring these programs to life so more families in rural America can consistently bring nutritious food home.
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The Rockefeller Foundation. Public Perception of Food is Medicine in Healthcare. 12 June 2025. https://www.rockefellerfoundation.org/reports/public-perception-of-food-is-medicine-in-healthcare/
Centers for Disease Control and Prevention. "Health Equity in Rural Communities." CDC, U.S. Department of Health and Human Services, www.cdc.gov/health-equity-chronic-disease/health-equity-rural-communities/index.html.
U.S. Department of Agriculture, Economic Research Service. "Chronic disease risk increased with U.S. household food insecurity." Charts of Note, USDA ERS, 4 Apr. 2024, ers.usda.gov/data-products/charts-of-note/chart-detail?chartId=108913.
Instacart. 2025 Economic Impact Report. Instacart, 13 Nov. 2025, www.instacart.com/company/static/pdfs/2025-instacart-economic-impact-report.pdf.
Instacart. "Instacart and TriMet Pilot Program Expands Access and Independence for Older Adults and Riders with Disabilities, While Saving Millions for the Transit Agency." Instacart Newsroom, 16 Oct. 2025, www.instacart.com/company/pressreleases/instacart-and-trimet-pilot-program-expands-access-and-independence-for-older-adults-and-riders-with-disabilities-while-saving-millions-for-the-transit-agency.
Wong, Karen. Online Shopping for Low-Income and SNAP Families: Micro-Report. University of Kentucky, Share Our Strength/No Kid Hungry, and Instacart, Sept. 2022, www.nokidhungry.org/sites/default/files/2022-09/NKH-Instacart-Online-Shopping-Micro-Report-v2.pdf.
Instacart. "Instacart and Foodsmart Partnership Drives Significant Clinical Outcomes for Members with Diet-Related Chronic Conditions." Instacart Newsroom, 21 Oct. 2024, www.instacart.com/company/pressreleases/instacart-partnership-drives-significant-clinical-outcomes.
Sarah Mastrorocco
Author
Sarah Mastrorocco is Vice President and General Manager of Health for Instacart. A longtime Instacart veteran and leader, Sarah today oversees Instacart Health, designed to support businesses, nonprofits and consumers across three key areas: Nutrition Security, Making Healthier Choices Easier, and Food as Medicine. Sarah has played an integral role at Instacart since joining as the first member of the company’s business development team in 2014. During her tenure at Instacart, she’s taken on various leadership positions across Business Development, Account Management, and Catalog. Prior to this current role, Sarah oversaw and scaled Instacart’s Pickup business.
