Blue Cross and Blue Shield of Minnesota s. Market Bucks Pilot Program at Midtown Farmers Market

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1 Blue Cross and Blue Shield of Minnesota s Market Bucks Pilot Program at Midtown Farmers Market Summary of evaluation findings

2 Innovative collaborations support low-income Minnesotans access to local farmers markets Blue Cross and Blue Cross Blue Shield of Minnesota (Blue Cross) is dedicated to making a healthy difference in the lives of all Minnesotans. In an effort to slow increasing trends of obesity and chronic disease in the state, Blue Cross collaborates with community agencies to create environments that support healthy eating and physical activity in everyday life. Midtown by providing a dollar-for-dollar match, up to $5 per day, for each dollar of SNAP benefits used at the market. In addition, Blue Cross collaborated with the City of Minneapolis and the Institute for Agriculture and Trade Policy to launch a citywide coordinated campaign to let SNAP customers know they could use EBT and Market Bucks at Midtown and two other Minneapolis farmers markets. 2 The promotional campaign included radio and newspaper ads, bus stop placards, signage inside and outside of the markets, flyers and targeted outreach to community agencies that serve low-income residents of Minneapolis. The goals of the promotional campaign and Market Bucks program were to increase the number of SNAP customers shopping at the farmers markets and to supplement their ability to purchase more fruits and vegetables. The following summary of evaluation findings covers Blue Cross Market Bucks pilot program. In 2010 Blue Cross worked with the Midtown Farmers Market (Midtown) in Minneapolis to make locally grown fruits and vegetables more accessible to lowincome residents, a goal supported by the Centers for Disease Control and Prevention, the U.S. Department of Agriculture and national food security advocates. i-iii Since 2006, Midtown has accepted payments from low-income customers who participate in the Supplemental Nutrition Assistance Program (SNAP), which relies on an electronic benefits transfer (EBT) system. 1 Through the Market Bucks program piloted during the 2010 market season, Blue Cross helped expand SNAP customers purchasing power at 1 SNAP is the federal program formerly known as Food Stamps. EBT allows SNAP recipients to make food purchases with a debit card preloaded with their monthly benefit amount and replaces the previous paper voucher system. 2 The City of Minneapolis worked with two other Minneapolis markets (Lyndale Avenue Farmers Market and Northeast Minneapolis Farmers Market) to launch EBT service for the first time in 2010 and provided funding for a Market Bucks incentive program at these two markets. More SNAP customers shop at Midtown and they shop more often Compared to the 2009 market season, the number of SNAP customers shopping at Midtown more than doubled in 2010, from 98 to 235 (Figure 1). Total Number of SNAP Customers [ Figure 1 ] Cover and page 2 photos used by permission of the Midtown Farmers Market. 2

3 The average number of days that SNAP customers shopped at the market increased from 1.7 days per customer in 2009 to 2.6 days in 2010 (Figure 2). This pattern of more frequent shopping is not altogether unexpected, since fresh fruits and vegetables tend to be purchased as needed, and the Market Bucks incentive was offered on a per day basis. Average Number of Shopping Days per SNAP Customer [ Figure 2 ] EBT transactions more than tripled, SNAP dollars more than doubled Total EBT Transactions [ Figure 3 ] As a result of the higher volume of SNAP customers and their more frequent shopping, the total number of EBT transactions in 2010 rose sharply in comparison to previous years. In fact, while there had been a steady increase in the number of EBT transactions each year since the service was first offered at Midtown, the total number of EBT transactions in 2010 was three-and-ahalf times the number of transactions in 2009 (Figure 3). On a daily basis, the average number of EBT transactions increased from about four (3.8) transactions per day in 2009 to about 13 (12.5) per day in Not surprisingly, the increase in the number of EBT transactions was accompanied by an increase in the total dollar amount of SNAP benefits used at the market. The total dollar value of SNAP benefits redeemed at Midtown in 2010 ($6,756) was more than double that in 2009 ($3,106) (Figure 4). Including $2,882 in Market Bucks that were issued, the total dollar value of SNAPrelated purchasing power at Midtown in 2010 ($9,638) was more than triple that in 2009 ($3,106). 3 Total SNAP Dollars and Market Bucks [ Figure 4 ] $504 $1,475 $3,106 $9,638 $2,882 $6, It is not known how much non-ebt money SNAP customers spent at Midtown in addition to SNAP benefits redeemed and Market Bucks issued, so total purchases made by SNAP customers in each year could be greater than amounts presented here. SNAP Benefits Market Bucks 3

4 The increase in the total value of SNAP benefits used at Midtown appears to have occurred primarily through greater frequency of shopping at the market rather than through spending more SNAP benefit dollars per visit. In fact, in 2010, the average EBT charge per SNAP customer per day was $11.24 compared to $18.82 in After adding in the $5 Market Bucks match per day, the average benefits used per SNAP customer per day was $16.24, still $2.58 less than in Word of mouth and promotions reached customers In a 2010 survey of 39 SNAP customers at Midtown, approximately eight out of 10 respondents said they learned that EBT service or Market Bucks were available at Midtown either through a source at the market itself or through word of mouth (75 percent for EBT, 80 percent for Market Bucks) (Table 1). SNAP customers were less likely to acknowledge promotional channels such as newspapers, websites and radio as sources of information about EBT service and Market Bucks. About half (49 percent) of survey respondents said they learned about EBT availability from a source at the market, and nearly two-thirds (64 percent) learned about Market Bucks that way. About one-quarter (26 percent) of survey respondents learned about EBT service availability by word of mouth, with around one in six (16 percent) respondents learning about Market Bucks that way. In the 2010 survey, SNAP customers were more likely (69 percent) to report that being able to use EBT was one of the main reasons they came to Midtown that day than they were to report that Market Bucks was one of the main reasons (42 percent). In post-season interviews, Midtown staff indicated their impression was that EBT availability at Midtown was often what brought SNAP customers to the market and Market Bucks was a pleasant surprise once they got there. Source of SNAP customer information about EBT service and Market Bucks [ Table 1 ] Source at the farmers market (for example, staff, market information booth) EBT at the market n (% of N=39) 19 (49%) Market Bucks n (% of N=39) 25 (64%) Word of mouth (for example, friend, relative, community organization or Women, Infant and Children [WIC] Program office) Community signage (for example, bus stop ads, signs outside the market) 10 (26%) 6 (16%) 6 (16%) 1 (3%) Newspaper (for example, city, community or neighborhood paper) 4 (10%) 5 (14%) Website or blog 4 (10%) 2 (5%) Radio 1 (3%) 1 (3%) NOTE: Respondents could choose more than one answer. Therefore, the sum of percentages exceeds 100 percent and category totals may not equal the sum of subcategories. 4

5 While relatively few SNAP customers reported learning about EBT service and Market Bucks from communications sources such as newspapers, websites or radio, one should refrain from discounting the value of these other sources too quickly. It is possible that information passed through word of mouth may have originated from some of the less-often-cited sources of information. While it is not possible to attribute causality to either paid communications or word of mouth channels, Midtown clearly was successful in bringing in new customers and increasing overall EBT sales, with the period of peak SNAP benefit use (August September 2010) coinciding with the timing of the highest concentration of promotional and outreach activities (Figure 5). In previous years without such promotions, the EBT sales were essentially flat from July to October. Monthly Total EBT Transactions [ Figure 5 ] SNAP customer satisfaction is high Overwhelmingly, SNAP customers were satisfied with Market Bucks and EBT service at Midtown and agreed that both components were easy to use. All 39 SNAP customers surveyed (100 percent) reported that they would shop at the market in the future, with or without the Market Bucks incentive. Survey respondents reported they were either satisfied (26 percent) or very satisfied (62 percent) with their experience using EBT and Market Bucks at the farmers market, or that, as first-time shoppers, it was too soon to tell (13 percent). Similarly, unless they had indicated it was too soon for them to form an opinion, all respondents either agreed or strongly agreed that using EBT or Market Bucks at Midtown was easy. In open-ended comments, survey respondents expressed positive feedback and appreciation for Market Bucks in particular. Suggestions for improvement were mostly regarding the desire to increase awareness about Market Bucks. Comments included: $1,600 $1,200 $800 $400 $0 JUN JUL AUG SEP OCT l > Thanks. This is [a] really great program. I buy much more local produce and enjoy coming to the market. l > Love this market. Like the local and fresh [food]. Born and raised in MN. Want to support farmers. l > Market Bucks is an awesome program and it allows EBT funds to get stretched a little further. l > Give more info to WIC office so more people know. When asked whether they would continue to shop at Midtown if the Market Bucks incentive were no longer offered, all respondents said they would, although eight (21 percent) said they would shop at the market less often in that situation. 5

6 Fruits and vegetables were preferred over other eligible foods While Midtown sells a variety of food items that can be purchased with SNAP benefits, including meat, cheese, eggs and bread, SNAP customers were much more likely to use Market Bucks and EBT to buy fresh fruits and vegetables (87 percent) than other food items (13 percent). Among survey respondents who were returning SNAP customers, six in 10 reported that the Market Bucks program positively affected the amount of fruits and vegetables they ate, albeit modestly. Forty-six percent reported they ate a little more fruits and vegetables because of Market Bucks and 13 percent reported they ate a lot more. Recommendations Based on the evaluation findings and staff experiences from the 2010 pilot at Midtown, the addition of the promotional and outreach campaign and the Market Bucks incentive match was successful in drawing SNAP customers to the market. The investment in word-ofmouth communications strategies and signage at the market appeared to be particularly valuable and should be considered for expansion in future years. Market staff noted that if Midtown s success in attracting additional SNAP customers continues to grow, there clearly will be a need for additional staff time to process EBT payments and for additional, faster EBT machine capabilities. Next steps l > Develop a long-term plan to make EBT accessible at more farmers markets in Minnesota, to make it more cost-effective for markets and vendors, and to promote EBT usage at farmers markets among SNAP customers through targeted promotions and Market Bucks. l > Expand Market Bucks to more farmers markets in Minneapolis in collaboration with the City of Minneapolis. This effort aims to strengthen citywide efforts to reduce EBT administration costs and enhance collaboration among all Minneapolis markets. l> Launch Market Bucks at the St. Paul Farmers Market, which plans to pilot EBT availability at a limited number of locations in l > Launch Market Bucks in conjunction with the Minnesota Farmers Market Association, which will work with eight farmers markets around the state to implement EBT in To download a PDF of this report, visit bluecrossmn.com/preventionminnesota. For more information on Blue Cross Market Bucks project, centerinfo@bluecrossmn.com. i Khan, L. K., Sobush, K., Keener, D., Goodman, K., Lowry, A., Kakietek, J., et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Reports Recommendations and Reports, 58(RR-7), July 24, ii USDA Agricultural Marketing Service, USDA Food and Nutrition Service, Project for Public Spaces, Inc. Supplemental Nutrition Assistance Program (SNAP) at Farmers Markets: A How-to Handbook. Washington, DC: USDA Agricultural Marketing Service. July Available at: iii Briggs S, Fisher A, Lott M, Miller S, Tessman N. Real Food, Real Choice: Connecting SNAP Recipients with Farmers Markets. Community Food Security Coalition & Farmers Market Coalition. June Available at: SNAP_FarmersMarkets.pdf 6 C2226 (4/11)