Pegasystems and Milliman Care Guidelines Deliver Next-Generation Capabilities for Care Management

MIAMI, FL – Milliman Care Guidelines Client Forum – April 20, 2009Pegasystems Inc., (NASDAQ: PEGA), the leader in Business Process Management (BPM) software solutions, and Milliman Care Guidelines, the standard-bearer in evidence-based clinical guidelines, today announced the availability of seamless integration between the two companies’ best-in-class offerings for the benefit of healthcare organizations and their members.  This integration enables healthcare organizations to improve the efficiency and quality of patient services through a single, integrated solution.

“Most care management deployments that Gartner analyzed in 2008 experienced significant challenges, because health insurers selected unproven products on new technology platforms,” said Joanne Galimi, Research Vice President at Gartner. “A comprehensive and proven care management application solution that combines standardized clinical strengths with a rules-based workflow solution is a good addition to the care management market for healthcare insurers.”

Seamless packaged integration is now provided through Pegasystems’ Care Management Framework solution to Milliman CareWebQI®; software that provides interactive access to evidence-based clinical content of the Milliman Care Guidelines®. These annually updated guidelines including Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines, enable case workers to support appropriate clinical decisions with evidence-based medicine across the continuum of care. Integration of the two solutions allows healthcare organizations to utilize industry-leading clinical care expertise with cutting-edge BPM technology and automated best-practice healthcare workflow capabilities to deliver care management services to their member populations.

“Pegasystems’ Care Management Framework provides the ideal balance of technology and industry expertise, with proven solutions across the healthcare enterprise,” said Scott Harris, Milliman Care Guidelines Senior Vice President of Sales and Marketing. “Our relationship with them makes the Care Guidelines more actionable to healthcare organizations across the continuum of care, and further extends our commitment to ensure best-practices and standards of excellence in healthcare.”

“Care Management has been underserved by technology for too long especially since technology has been adding such value to other parts of the healthcare enterprise,” said Elizabeth Hart, Senior Director, Healthcare Solutions for Pegasystems. “Our relationship with Milliman Care Guidelines addresses both the technical and clinical needs of our customers. The integration of clinical content through Pegasystems’ rules-based BPM engine is an important step towards fully automating processes, while ensuring the right care is given when and where it is needed.”

Unveiled today at the Milliman Care Guidelines Client Forum, the integration between Pegasystems and Milliman will be discussed and demonstratedata presentation delivered by Mary Tamir, Product Manager for Pegasystems.  The presentation, entitled “BPM for Next-Generation Care Management”, is being held from 4:00 – 5:15 pm at the Client Forum, taking place at the Doral Golf Resort and Spa.

About Pegasystems’ Care Management Framework (CMF)

Built on Pegasystems’ industry-leading SmartBPM® platform, CMF is a patient-centric business process management solution that automates the creation and on-going improvement of personalized care management programs. By unifying disease management, case management, and utilization management across the healthcare enterprise, CMF gives care professionals the ability to provide whole person care and also collaborate in real-time with the entire patient-network. CMF can also reduce overall care management complexity, cut utilization costs, and reduce cost of care management program development by 40-60 percent. These efficiencies are especially needed now as the healthcare system faces a tidal wave of aging baby boomers, more likely to demand and respond well to proactive care programs.

Pegasystems’ healthcare solutions are widely-used by major healthcare organizations including three of the top five US health plans and more than 50 percent of the Blues network, representing over 100 million covered lives. To find out more about Pegasystems’ healthcare offerings visit


About Milliman Care Guidelines

Milliman Care Guidelines is located in Seattle, and independently develops and produces evidence-based clinical guidelines and a variety of software options that are used by more than 1,000 clients, including seven of the country’s eight largest health plans, to support the care of nearly two-thirds of US health plan members.  Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced team of clinicians.  For more information, visit

Milliman Care Guidelines LLC is a wholly owned subsidiary of Milliman, Inc. Milliman is among the world’s largest independent actuarial and consulting firms.  Founded in Seattle in 1947 as Milliman & Robertson, the company currently has 49 offices in key locations worldwide.  Milliman employs over two thousand people, with a professional staff of more than a thousand qualified consultants and actuaries, including specialists ranging from clinicians to economists.  The firm has consulting practices in healthcare, employee benefits, property & casualty insurance, life insurance and financial services.  Milliman serves the full spectrum of business, financial, government, union, education and nonprofit organizations.  For further information, visit

About Pegasystems

Pegasystems (NASDAQ: PEGA) develops strategic applications for marketing, sales, service, and operations. Pega’s applications streamline critical business operations, connect enterprises to their customers seamlessly in real-time across channels, and adapt to meet rapidly changing requirements. Pega’s Global 3000 customers include many of the world’s most sophisticated and successful enterprises. Pega’s applications, available in the cloud or on-premises, are built on its unified Pega 7 platform, which uses visual tools to easily extend and change applications to meet clients’ strategic business needs. Pega’s clients report that Pega gives them the fastest time to value, extremely rapid deployment, efficient re-use, and global scale. For more information, please visit us at

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The information contained in this press release is not a commitment, promise, or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described remains at the sole discretion of Pegasystems, Pegasystems specifically disclaims any liability with respect to this information.


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