Healthcare hero

Pega Care Management Application

Improve health outcomes.

"Going forward, Pega is like our conductor. It's the orchestrator of our systems."
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Get to know Pega Care Management Application

Bring data to life with
personal health plans

Each patient has their own health journey. Pega Care Management delivers a unique combination of managed care best practices and real-time connected data. Personalized care planning empowers care teams and patients to drive optimal outcomes across all settings.

Improve outcomes with
clinical guidelines

Pega promotes best practices to help lower costs and improve health outcomes. Standard clinical guidelines and local business rules inform and guide clinical care teams as they manage patient needs and requests across the continuum of care.

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Empowered population health

Drive efficiency with a unified process across utilization management, disease management, care management, and health and wellness. Pega provides easy access to patient profiles, plan benefits, claims, authorizations, and clinical data, providing opportunities to promote population health programs.

Reduce gaps in care with
health risk assessments

Drive a system of coordinated heath care assessments, interventions, and communications for defined patient populations. Identify and support self-care efforts to produce quality outcomes, all while boosting organizational HEDIS and Star scores.

Adapt and comply with
on premises or on cloud

Pega Cloud Services enable healthcare organizations to accelerate business objectives while meeting requirements for performance, data security, and HIPAA compliance. Immediate access allows you to rapidly create, test, deploy, and manage applications.

Additional Product Features

Pega’s integrated platform enables the collaboration essential to quality care management.

Engage patient consumers throughout their journey with sophisticated service capabilities.

Reports provide insights for organizations see opportunities to improve operational excellence.

Pega simplifies sending educational materials and letters for health and wellness programs.

Intuitive and actionable data provides insights for better patient care.

Connect the internet of medical devices with care teams so abnormal value alerts become actionable.

Automate intelligent appeals, grievances, and complaints management.

Clinical Assessments

Everything from standard federal program assessments to short, actionable pain assessments included.

Flexible, Configurable Reporting

Business users can configure their own reports to see exactly the data they want and need.

Customer Case Studies

See how customers are using Pega Care Management Application to transform their enterprises.

Anthem Creates Next-Generation Service Desktop With Pega Customer Service

Anthem implemented a next-generation service desktop powered by contextual, relevant decisions.

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Case study

Alere: Closing Gaps in Health care
Learn how Alere reduced gaps in care by over 60% in just 12 months.
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Case Study

MGEN’s Global Enterprise Transformation

MGEN used Pega’s Customer Service for Healthcare to improve service response, consistency, efficiency, reporting, and alignment across all channels.

See how Pega can help your business

Talk to an expert and see how Pega can transform your customer experiences with next-generation software applications and solutions.