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Healthcare Management Technology

This is an era of profound change in healthcare information technology. The migration to electronic health records (EHR), the growth of cloud-based healthcare applications, and the emergence of “big data” analytics are just a few features of the new healthcare IT landscape.


Pega 7 provides tools for business people to define the major steps of how work gets done.

Analyst Report

Pegasystems commissioned Forrester Consulting to conduct a TEI study to examine the potential return on investment (ROI) enterprises may realize by deploying the Pega 7 Platform.

For these and other IT advances to have value for the modern healthcare enterprise, however, requires healthcare management technology that can bring disparate IT assets to bear on the daily conduct of business. More particularly, payers and providers need healthcare management technology that can link diverse, distributed health information systems and applications into the routine business processes and customer service processes that are the lifeblood of the organization.

Pegasystems: Healthcare Management Technology for the Digital Healthcare Enterprise

Pegasystems is the leading developer of intelligent business process management (iBPM) technology and customer relationship management (CRM) technology. Pega’s Better Business Software® provides iBPM and CRM solutions for a range of IT-intensive industries, including our healthcare management technology for healthcare payers and providers. Many of the world’s largest healthcare organizations use a Pega healthcare management system to improve health outcomes and reduce operating costs.

A Pega health management system facilitates easy, standards-based integration with your existing healthcare software systems and data sources so that you can derive greater business value from those systems while streamlining and optimizing business processes across the enterprise. With healthcare management technology from Pega, you can:

  • Design, model, and implement automated and semi-automated business processes that orchestrate people, systems, and data to dissolve organizational silos, optimize workflow, eliminate waste, and improve process outcomes.
  • Put relevant information and guidance in the hands of frontline personnel—marketers, sales reps, service reps, care managers, underwriters, claims adjusters, and more—exactly when they need it, to support decisions that best meet the needs of customers as well as the objectives of the organization.

With Pega’s Build for Change® technology, business users can drive the design and creation of business process applications that run on the Pega platform. No programming is necessary—the application code is automatically generated by the system.

Pega Healthcare Management Technology Featured Solutions

On top of our core platform, Pega offers healthcare management solutions that further simplify the creation of organization-specific applications and speed time to value. These healthcare software solutions provide pre-defined data models, workflows, decision tables, user interfaces, and HIPAA-compliant industry components. Pega’s suite of healthcare management applications includes tailored solutions for:

  • Product Creation
  • Sales and Enrollment
  • Customer Service
  • Marketing and Retention
  • Care Management
  • Claims Processing
  • Medicare and Medicaid
  • Compliance
  • Appeals and Grievance

Learn more about how Pega healthcare management technology can help your organization optimize business processes and get more value out of existing IT systems.