Chronic Disease Pledge Bright Spot: UPMC Health Plan Prescription for Wellness

September 19, 2024

Pittsburgh-based UPMC Health Plan is committed to reducing the incidence of diabetes in its community as part of the ACHP Chronic Disease Pledge. With high rates of diabetes across the country and nearly 38% of adults having prediabetes, UPMC is focused on developing strategies that mitigate risk factors for this costly chronic condition. 

UPMC launched a new referral system called Prescription for Wellness in 2014, offering clinicians a convenient and effective way to refer members to diabetes management support and additional clinical services. This system is customized to each member’s specific physical and behavioral health needs. Personal services, such as health coaches, help people reach their goals, while community support and online resources help them better understand their health status and care options. Consultations with health coaches are offered by phone, video and chat to accommodate preferences and increase accessibility. Access to the portal is available to all care teams, including primary care physicians, specialists, physical therapists and social workers to ensure collaboration and touchpoints.   

While implementing a new referral system comes with its challenges, UPMC identified multiple barriers and ways to overcome them. A significant challenge was securing total adoption of the Prescription for Wellness program with clinicians due to time constraints and competing priorities. UPMC has mitigated the issue by making it as user-friendly as possible and ensuring consistent communication and feedback with clinicians.  

An additional barrier was ensuring clinicians understood the program’s value and overall ROI. UPMC conducted a case study on the program that demonstrated its benefits, value and effectiveness in supporting patients’ diabetes management. An award-winning paper evaluated the program to convey the lasting impact and powerful value the program has on health outcomes and patient care. Lastly, ensuring general awareness about the program and its resources among members is critical to its utilization. Most recently, UPMC launched an initiative to promote the program and its resources among UPMC members.  

Throughout the nearly 10 years since the launch of the Prescription for Wellness program, UPMC has identified key considerations for its successful implementation. First, UPMC emphasizes the importance of relationships, leadership and organizational culture when implementing successful and effective innovations like this one. Additionally, working with trusted community partners and engaging clinicians to utilize the program helps improve members’ lives and elevates the program’s success. Finally, expanding access to care through telehealth and collaborative care models supports primary care offices and cultivates receptiveness to programs such as Prescription for Wellness.  

Through innovative initiatives such as Prescription for Wellness, UPMC continues to work towards its commitment to ACHP’s Chronic Disease Pledge and looks forward to continued success in improving patient health and addressing diabetes care and prevention.