Use Pega Build For Change® technology to achieve rapid and measurable value
With Pega, healthcare organizations can revolutionize the way they cut costs, respond to regulations, enhance the customer experience and manage change. Pega solutions for healthcare instantly adapt to each situation and customer and work easily within your existing architecture to promote seamless interactions across all channels and streamline work from end-to-end. Leveraging Pega's agile Build for Change® technology, Pega solutions help healthcare companies achieve new levels of innovation, better health outcomes and outstanding customer experiences - all at lower cost.
Healthcare leaders, including 19 of the top 22 largest U.S. healthcare payers and over half of the Blues plans rely on Pega for one very good reason - Pega delivers results. Only Pega automates complex business functions with dynamic processes that streamline front- to back-office operations, deliver member-focused service, meet regulatory requirements and enable new products and services to be delivered at a faster pace.
Pharmacy Benefit Managers
Deliver outstanding customer experiences at substantially lower cost. Pega connects all of the systems, processes and channels needed to streamline formulary management, automate clinical guideline compliance and promote shared-business processes that deliver better visibility and control to plan sponsors and prescription drug manufacturers – and memorable service to members and providers.
Providers / IDNs / ACOs
Gain the level of flexibility needed to succeed with new, risk-based opportunities while continuously delivering patient-centered care. Pega leverages and extends existing systems across department and corporate siloes with intelligent processes that dynamically apply the right guidance at the right time and connect all of the people, systems, data and channels required to complete work. The result is high-performance operations that do away with manual and redundant effort, enabling accountable care entities to focus on the patient/member – not the process.
With Pega, healthcare agencies can revolutionize the way they cut costs, respond to regulations, enhance the customer experience and manage change. Pega solutions for healthcare instantly adapt to each situation and customer and work easily within your existing architecture to promote seamless interactions across all channels and streamline work from end-to-end.
Medicare and Medicaid
From comparison shopping, sales and enrollment to customer service, billing, prior-authorizations, MTM management and more, Pega offers solutions for managing both public sector and healthcare payer programs such as Health Insurance Exchanges (HIX); Medicare Advantage and Medicare Part D; Medicaid including MMIS, and new or unique federal healthcare programs spanning numerous organizations and populations (including the military and Federal Employee Plan (FEP)) and initiatives (including meaningful use attestation).
Pega 7 delivers solutions 6.4X faster than traditional Java EE. The Build for Change platform brings new solutions to life with simplicity and speed for adaptability to changing business needs.