Pegasystems Delivers BPM Best Practices and Enhances Competitive Edge for Healthcare Payers; Framework Packages Payer, Member, and Regulation Expertise

CAMBRIDGE, Mass., Aug. 23, 2005 — Healthcare payer organizations face a myriad of daunting challenges: preparing for the rollout of the Medicare Part D prescription drug plan, carving out a profitable niche in consumer-directed healthcare and ensuring quality-of-care while attempting to control costs. In response, Pegasystems Inc. (Nasdaq: PEGA), the leading provider of smart business process management (BPM) software, today announced the release of its Payer Industry Framework.

By leveraging the pre-built foundational elements of the Industry Framework with Pegasystems' leading SmartBPM Suite, payers can rapidly build customized solutions such as Medicare Part D marketing and enrollment-management applications or tools to help their members manage their new healthcare-savings accounts. The flexibility offered by Pegasystems' rules-driven BPM platform helps payer organizations obtain agile solutions that deliver sustainable competitive advantage.

The Payer Industry Framework provides best-practice work templates for rapidly creating SmartBPM solutions that deliver productivity, spur growth, and ensure compliance. It includes core features and functions that accelerate the development of customized solutions for payer organizations' biggest challenges. Included in the release are authorization-process workflows, healthcare service levels, and correspondence-generation and Web service-message intake and responses. The framework also includes HIPAA EDI templates and a HIPAA-compliant healthcare data model.

"Healthcare payers need to quickly respond to changes in the market, while maintaining solid relationships with their members and their network of providers," said Jay Sherry, Vice President of Marketing and Solution Development for Pegasystems. "Our long-term relationships with healthcare payers and their stakeholders, and our experience with government regulations, have yielded a plethora of best industry practices that can rapidly be deployed and easily extended throughout the organization."

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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