Pega Care Management Application

 Improve health outcomes with
Pega Care Management Application

Improve care

One patient, one record: Empower care teams to drive optimal health outcomes across all settings with Pega’s managed care best practices, real-time connected data, and personalized care planning.


Every member of the patient health continuum, from care managers to home health caregivers to nurse practitioners to physicians, can use Pega’s unified, collaborative platform to manage patient care.


Pega helps you streamline the timely delivery of appropriate services to patient consumers while at the same time providing the structure for your most cost-effective outcomes.
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.

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.
“Going forward, Pega is like our conductor. It's the orchestrator of our systems.”

Jeff Ganser, Director, IT Project Management, UnitedHealthcare Global

“Going forward, Pega is like our conductor. It's the orchestrator of our systems.”

Jeff Ganser, Director, IT Project Management, UnitedHealthcare Global

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.
Everything from standard federal program assessments to short, actionable pain assessments included.
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.
Business users can configure their own reports to see exactly the data they want and need.
Connect the internet of medical devices with care teams so abnormal value alerts become actionable.
Automate intelligent appeals, grievances, and complaints management.