Pegasystems Delivers Intelligent, Agile Healthcare Software Solutions

Healthcare organizations are being squeezed on all sides, with soaring costs, demanding consumers, and ever-growing government mandates. To manage these pressures, providers and payers need healthcare software solutions that hold down costs while meeting customer needs and providing the transparency that regulatory compliance requires. Many of the world’s leading healthcare organizations turn to Pegasystems for innovative, reliable healthcare software solutions, including the three largest U.S. healthcare payers, top pharmacy benefit managers, and over 60% of BlueCross and Blue Shield plans.


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The Total Economic Impact of the Pega 7 Platform

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.

Powered by the industry-leading Pega business process management (BPM) platform, Pega healthcare software solutions enable healthcare enterprises to intelligently automate their core business functions, including new customer acquisition and on-boarding, customer relationship management, risk management, and compliance management. With Pega healthcare software solutions powered by Pega BPM, you can incorporate key business objectives and best practices directly into streamlined, automated processes that are applied consistently across the organization, driving down operational costs while satisfying customer needs and regulatory requirements.

Easily integrated with your existing IT systems and featuring our patented Build For Change® technology that puts business users firmly in control of the change management process, Pega BPM also provides an ideal platform for related solutions like insurance policy management software, regulatory compliance management software, and fraud case management applications. The fast-paced, high transaction volume world of financial services has been another proving ground for Pega BPM-based applications, as many of the top U.S. and global banks and brokerages rely on Pega financial services software and financial services solutions.

Real-World Results

Some of the largest healthcare organizations in the world have achieved impressive results with Pega healthcare software solutions. For example:

  • A regional BCBS plan using Pegasystems for new program creation and for client on-boarding was able to reduce its new program cycle time by 75 percent and reduce its enrollment processing time by 80 percent.
  • A major service provider used Pegasystems as the foundation for its Medicare Part D operations, and achieved top customer service awards as well as dramatic operational efficiencies including reduced training time and call handling time.
  • Another BCBS plan used Pega healthcare software solutions to reduce call handle times by 26 percent in its HMO business and 17 percent in its PPO business.
  • A major payer used Pega BPM as the platform for building and deploying more than a dozen process-automating applications across the enterprise, and realized $20 million in annual savings.


Learn more about Pega healthcare software solutions.