UPMC Health Plan


Denise Hughes
UPMC Health Plan


UPMC Health Plan’s “Impact of Physician Referral” Publication Wins Paper of the Year Award from American Journal of Health Promotion

Prestigious award honors best health papers and those who bring outstanding humanity to fields of medicine

Pittsburgh (Feb. 16, 2021) – UPMC Health Plan has received the prestigious American Journal of Health Promotion “Papers of the Year from 2020 Award” for its “Impact of Physician Referral” outcomes study, the company announced today. The study evaluated the impact of leveraging the credibility of the provider’s “white coat,” as physicians essentially “prescribed” health coaching for their patients to improve patients’ health and better manage disease.

The study demonstrated a 300 percent greater patient engagement in health coaching compared to traditional outreach approaches when physicians used UPMC Health Plan’s Prescription for Wellness. This innovative program enables physicians to refer patients for health coaching directly through the provider’s electronic medical record’s linkage to the Health Plan. This unique approach, designed using the 6 Sigma process, has been used by 2,000 providers to assist more than 40,000 patients to work with health coaches to improve their health, manage their conditions, or support better medical decision making. 

“As part of an integrated delivery and finance system, UPMC Health Plan is able to use all the levers at our disposal—from strong provider relationships to nationally certified and experienced health coaches to digital programs—to help our members improve their health and better manage chronic conditions,” said Dr. Michael Parkinson, senior medical director, UPMC Health Plan and Workpartners, and the paper’s lead author. “As our study shows, patients trust their doctors, and individuals are much more likely to engage with our coaching programs when the physician ‘prescribes’ education and support as a critical part of the patient’s care plan.”

The paper, Impact of Physician Referral to Health Coaching on Patient Engagement and Health Risks: An Observational Study of UPMC’s Prescription for Wellness, was published by a team of UPMC Health Plan colleagues: Parkinson, MD, MPH, FACPM; Tracy Hammonds, PhD; Donna Keyser, PhD, MBA; Pamela Peele, PhD; and Jennie R. Wheeler, MBA.

The study sought to evaluate impact of physician referral to health coaching over a four-year, retrospective, observational period among UPMC Health Plan members enrolled in programs delivered by health coaches.

Increasingly recognized as one of the leading causes of rising health care costs, preventable lifestyle diseases are an area where health care delivery systems and health insurers are proactively deploying innovative approaches to optimize the health of their members. Solely relying on traditional methods of patient education has yielded limited results. Health coaching provides education and support for patients to improve their health behaviors, manage chronic disease, and make better informed decisions. Those strategies have been effective in addressing health care and cost challenges.

Since 2008 UPMC Health Plan has offered evidence- and curriculum-based health coaching lifestyle programs at no cost to members. All UPMC Insurance Service Division lifestyle health coaches pass a rigorous in-house training program that is one of only a few accredited by the National Board for Health and Wellness Coaching. The study demonstrated the impact of the Prescription for Wellness integrated “people, process, and technology” design. It makes efficient use of the provider’s in-office time and clinical expertise, immediately transmits “prescriptions for coaching” to a Health Plan health coach, and provides timely feedback to the provider in 30 days, noting the patient's progress.

The intervention group consisted of more than 14,400 adult insured members who were referred by physicians to health coaching programs through Prescription for Wellness from July 2014 through June 2018. Patients were three times more likely to engage in health coaching when prescribed by their physician using Prescription for Wellness than a matched comparison group of members who were contacted through Health Plan outreach only. Among the members referred to health coaching through Prescription for Wellness, 80 percent were referred to improve lifestyle behaviors as nutrition, physical activity, and tobacco cessation, while the remainder were referred for chronic disease management. Overall, patients experienced a significant reduction in health risks known to be associated with chronic disease and increased health care costs.


About UPMC Insurance Services

Serving more than 3.9 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids). Also part of UPMC Insurance Services is Community Care Behavioral Health, one of the nation's largest managed care behavioral health organizations. For more information, visit upmchealthplan.com.