Prescription for Wellness: A Decade of Provider-Payer Collaboration in Action

Patient engagement remains one of health care's biggest challenges. Even when health plans offer evidence-based wellness, care management, and support services, participation is often limited when outreach occurs outside the patient-provider relationship.

A recently published article¹ describes how UPMC's Prescription for Wellness (PFW) program addresses this challenge with a platform for providers to refer UPMC Health Plan members to payer-sponsored resources that support chronic condition management, lifestyle change, behavioral health, and social needs directly from their workflow at no cost to the member. The program is built on a simple premise: patients are more likely to engage when services are recommended by a trusted clinician.

Technology plays a critical role. Embedded within the electronic medical record (EMR) and UPMC Health Plan’s secure Provider OnLine portal (to accommodate practices on an alternative EMR), PFW allows providers to prescribe services and receive feedback regarding patient outreach and engagement. This closed-loop communication strengthens care coordination and helps connect clinical care with wellness, behavioral health, and health-related social needs support.

Prescription for Wellness Outcomes 2014-2024

Provider Referral → Member Outreach → Service Engagement → Clinical Support

• 80,000+ members received a referral
• 75% were successfully reached
• 60% engaged in services
• 200,000+ clinical sessions completed

Building on more than a decade of implementation, the program facilitated over 8500 referrals in 2025, reaching 80% of referred members and engaging 62% in services. Those referrals resulted in nearly 12,700 clinical sessions, more than 7400 assessments, and over 1800 clinical interventions within 60 days.

After more than a decade of operation, the authors identify several keys to success: strong provider-payer partnerships, workflow-integrated technology, continuous performance monitoring, and ongoing engagement with clinician champions. Equally important is maintaining a shared focus on improving patient health through coordinated support and services.

By connecting patients with preventive and supportive resources, supporting care teams, addressing whole-person needs, and strengthening collaboration across organizations, the model offers a practical framework for advancing value-based care.

As health systems and health plans seek scalable strategies to improve engagement and population health, PFW provides an example of how provider endorsement, technology integration, and payer-provider alignment can work together to improve access to care and support better outcomes.

Read the full article for additional insights and lessons learned from the program's first decade.

Reference

1. Delu J, Sheffey C, Labriola S, Beckjord E. UPMC Prescription for Wellness: lessons learned from 10 years of progress and innovation. Am J Health Promot. Published online June 9, 2026. doi:10.1177/08901171261452426