The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental foods to low-income pregnant, breastfeeding, and postpartum women; infants; and children younger than 5 at nutritional risk. WIC state agencies (SAs) prescribe one of seven food packages—specifying which foods are authorized for purchase through the program—for each WIC participant. To ensure the best use of available funds, WIC SAs are expected to take steps to contain food package costs. Understanding the approaches SAs use to reduce food costs when selecting and authorizing supplemental foods—and the relative effectiveness of these approaches—is critical to developing useful policies for cost containment. Equally important is understanding the possible negative consequences of these practices on participant outcomes. For this study, Insight examined how six types of SA food cost-containment practices are associated with food cost savings and WIC participant outcomes (i.e., participant satisfaction, benefit redemption, and food consumption) in 12 state agencies. The six types of food cost containment practices were least expensive brand (LEB) restrictions, store-brand-only restrictions, manufacturer rebates for supplemental foods other than infant formula, container size restrictions, form or type restrictions, and food alternative restrictions. Insight conducted a document review; interviewed WIC SA staff; conducted surveys with WIC participants; and analyzed WIC EBT and administrative data, along with extant data on food prices. Using findings from the food savings and household outcomes analyses, the study team classified the 25 food specific restrictions into 1 of 4 categories: (1) cost savings and no adverse participant outcomes, (2) cost savings and some adverse participant outcomes, (3) no cost savings and no adverse participant outcomes, and (4) no cost savings and some adverse participant outcomes. These classifications and other important contextual information informed the following recommendations:
- Disseminate information about food-specific restrictions that reduced costs but were not associated with adverse participant outcomes: form and type for yogurt (no Greek) and infant fruits and vegetables (no organic) and container size for cheese (16 ounce only) and juice (no 48 ounce).
- Reconsider food-specific restrictions that did not reduce food costs and/or were associated with adverse participant outcomes: cow’s milk (no ultra-high temperature processing), tortilla brand (LEB), and cheese form or type