A seismic shift is underway in the healthcare marketplace as national reform legislation puts the squeeze on health plans’ profit margins and spending discretion while also opening tremendous new opportunities for growth. To thrive in this changing healthcare economy, healthcare payers must be agile in developing new products and campaigns, and execute well on their plans. Some of the most successful health plans are finding that their product development, marketing, and sales efforts benefit tremendously by utilizing healthcare software systems from Pegasystems.


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Pega Healthcare Software Systems for Product Creation, Marketing, and Sales

Pega healthcare software systems can help your organization protect and expand market share during this time of profound market change. Built on Pega’s industry-leading Build for Change® platform, Pega healthcare solutions streamline, automate, and bring real-time analytics to bear on the key business processes that position you to compete and win in today’s healthcare marketplace.

The Pega Product Composer System enables your team to rapidly design, approve, prepare, and roll out innovative new healthcare benefits and products. A rich library of product templates and reusable building blocks makes it easy to define benefits and assemble complete products. These healthcare software systems for product design and development also support push-button generation of compliant regulatory filing documentation such as Explanation of Coverage forms and DOI submission forms.

Pega Sales & Enrollment for Healthcare automates the end-to-end sales process from prospecting and lead assignment through to enrollment and fulfillment. Pega healthcare software systems for salesforce automation guide representatives through complex sales processes, at each step suggesting the best action to help close the deal. This revenue-boosting healthcare software includes different modules to support the different needs of group sales and individual sales.

Pega Marketing and Retention Solutions provide a collaborative environment for designing, launching, and managing automated multi-channel healthcare marketing campaigns that attract new prospects and strengthen relationships with existing customers. These healthcare software systems feature Pega’s unique Next-Best-Action Marketing technology which employs real-time analytics to dynamically recommend cross-sell and up-sell offers to service representatives as they engage with existing customers, based on factors specific to the customer and the interaction.

Pega Healthcare Software Systems for All Your Operational Challenges

Beyond product development, marketing and sales, Pegasystems offers solutions to a range of other healthcare management challenges. Pega’s suite of healthcare information systems and process management systems includes solutions for:

  • Customer service
  • Claims processing
  • Accountable care management and optimizing of health outcomes
  • Medicare and Medicaid program administration
  • Regulatory compliance
  • Appeals and grievance processing


With any Pega healthcare management system, you have your choice of on-premise deployment or taking advantage of the convenience of the Pega Cloud.

Learn more about Pega healthcare software systems.