The Challenge

Marketplace pressures and heightened government mandates are pushing healthcare organizations (HCOs) to deliver higher-quality, yet more cost-effective services. Today’s inflexible and siloed care management systems, anchored by aging technology platforms and sluggish manual processes, are insufficient for the current challenge. This challenge is heightened by new delivery mechanisms such as Accountable Care Organizations (ACOs) and reform incentives which increase the need for unified care management.

The Solution

Pega’s BPM-based Care Management Solution provides end-to-end, optimized care management spanning health & wellness and utilization, disease, and case management.

Our clients have garnered:

• 5x faster delivery of health & wellness programs
• 12% increase in automated authorizations
• 3x faster enrollment in care management programs
• 30% reduction in training costs