Fresh House sits on top of 65 years of Caribbean Produce Exchange and a documented record of operating at federal scale during the hardest moments in Puerto Rico's recent history. The credentials Food is Medicine asks for — cold chain, integration, compliance, community trust — we already built them. Three times.
When the federal government needed an operator that could move USDA produce across all of Puerto Rico during the COVID emergency, the answer was Caribbean Produce Exchange. These photos are from the operation that today's Fresh House Food is Medicine work sits on top of.
CPE is established as a fresh-food distributor in Puerto Rico. Grows into the island's leading fresh-food distributor with 2,000+ active SKUs and an islandwide cold chain — the operational backbone every Fresh House program runs on today.
Multi-decade alliance with the Caribbean Sea Turtle Stranding Network. Native species preservation through supplier alliances and consistent corporate giving.
Recurring contribution to the Municipality of Cataño's summer programs: healthy snacks for children. Still active today.
When María made landfall, Caribbean Produce activated a multi-month logistics alliance with the American Red Cross and FEMA. CPE's cold chain, distribution center and procurement network were placed at the service of the federal and humanitarian response. More than 3.2 million meals delivered over six months — at peak, over 10,000 elderly and food-insecure Puerto Ricans served per day. The alliance with the Red Cross would continue across future emergencies as a standing partnership.
When a sequence of strong earthquakes hit Puerto Rico's southwest, Caribbean Produce coordinated in-kind food contributions and labor support for affected communities, community-based organizations, displaced families and southwest agricultural farms and farm workers. Distribution into shelters, schools and municipal coordination centers across Guánica, Yauco, Peñuelas, Guayanilla and Ponce.
During COVID-19, CPE distributes 3 million USDA Farmers-to-Families food boxes in 9 months in alliance with 430+ nonprofits and faith-based organizations. Simultaneously launches food deliveries to Medicare elder members — the seed of today's Caja de Alimentos.
Caribbean Produce participates in the humanitarian-aid effort for Ukraine, contributing food and logistics capacity through international relief channels — extending the disaster-response capability beyond Puerto Rico for the first time.
Caribbean Produce reactivates the Red Cross / FEMA disaster-response playbook for Hurricane Fiona — cold-chain distribution, emergency procurement, and last-mile delivery to affected communities across the island. The post-María partnership infrastructure proves durable.
Launches medically-tailored food box pilot for renal patients with Fresenius Medical Care: low-K / low-P boxes, direct-to-patient. Significant clinical response observed in patient adherence.
Fresh House launches its first produce-purchase incentive for Medicare Advantage members in PR via a national payer. Validates the SFTP / member-data integration model that today powers all of FH's payer programs.
Fresh House launches Nutrisana — the only online grocery platform in Puerto Rico that delivers islandwide AND accepts NAP. The digital-access backbone.
200,000 food boxes distributed in partnership with Cáritas as part of federal emergency-response food.
Launches the healthy food box as a covered benefit for Medicare Advantage members in PR — 100% covered by the plan. Becomes the foundation for the 2026 launch at scale.
Partners with the Harvard T.H. Chan School of Public Health on a Culturally-Adapted Dietary Clinical Trial in Puerto Rico.
Awarded the USDA GUSNIP Nutrition Incentive grant. In partnership with Fundación MMM, launches a 1:1 produce incentive that doubles fruit and vegetable purchases for NAP recipients.
1:3 incentive launched with Banco de Alimentos PR — triples F&V value. Companion Produce Prescription pilot for diabetic patients (delivered via the Fundación MMM channel) shows significant HbA1c improvement.
Proposal presented to a Medicare Advantage payer in Puerto Rico to drive member retention and CMS Star Rating performance. Three components: prepared meals, grocery box, and a fresh-produce bonus via the payer's benefit card. Grounded in Tufts evidence (HbA1c −0.8%, F&V intake +22%, food insecurity −50%) and Harvard MTM evidence (ER −70%, hospital admissions −52%, healthcare cost −16%).
Grocery-box component launches across the eligible Medicare Advantage population in Puerto Rico. Strong satisfaction and near-perfect delivery success rate from month one.
Operations review documents the program's best month to date: record-high member satisfaction, record-low delivery failures, and record-low call-center abandonment. Eligible base continues to grow as enrollment expands.
Leading fresh-food distributor in Puerto Rico
Fresh House is the social-impact and direct-services division of Caribbean Produce Exchange. CPE operates with 2,000+ active SKUs, an islandwide cold chain, and a 65-year track record. Fresh House programs are contracted, billed, and operated exclusively through CPE.
Disclosure · independent entity
Nutriendo PR is an independent 501(c)(3) non-profit founded by members of the Grupo Navis family. Its mission is to build the Food is Medicine movement in Puerto Rico through public education, research dissemination, and policy advocacy. Nutriendo PR and Caribbean Produce Exchange operate at arm's length: separate boards, separate funding, no client-referral relationship and no shared revenue. Fresh House programs are operated and contracted exclusively through CPE.
The peer-reviewed evidence base for FAM has crossed the threshold from "promising" to "policy-grade." CMS's HRSN Coverage Framework (2023) and Section 1115 now allow states to reimburse medically-tailored meals, groceries, and produce prescriptions.
Sources: peer-reviewed studies summarized in the Grupo Navis Food is Medicine Executive Brief (2025). Reduction figures reflect FIM intervention cohorts; the national-savings figure assumes medically tailored meals reaching all eligible.
Hurricanes María/Irma/Fiona logistics
Hurricane María disaster logistics
Farmers-to-Families · GUSNIP · NAP
Renal CKD program · 2021–present
Medicare Advantage payer partnership
Medicare Advantage payer partnership
Medicare Advantage payer partnership
GUSNIP · Produce Rx · Adopta un Viejo
Wholesale supply · GUSNIP partner
Community-network distribution
Active Data Use Agreement
Project Precision trial
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