Pega for Healthcare

Personalizing engagement for better health outcomes.

Deliver Seamless, Omni-Channel Service

Service so flawless, they won’t believe it’s you

Do you really know who your members and constituents are? Sure, you try to keep their needs top of mind. But in the midst of constant regulatory changes, it’s easy to lose sight of the people you serve, especially when dealing with multiple channels and devices. And let’s face it, they don’t expect the best of you either.

With a growing population in need, you’ll need to be faster, smarter, and more personalized if you want to improve operational and health outcomes. That’s where Pega comes in.

Our customer service technology uses smart automation to let you streamline and simplify interactions. Deliver seamless service across channels. And harness AI-driven insights and guidance to ensure personalized, successful outcomes, every time.

Data Sheet

Pega for Government Healthcare

The Pega Healthcare for Government solution is a fully integrated, unified government platform.

Read More
Data Sheet

Pega Care Management Application

The Pega Care Management solution is a unified platform that enables care teams to deliver innovative, patient-centric programs.

Read More

Achieve Superior Member Outcomes

The outcomes you want. The speed and agility you need.

Personalized healthcare at scale and operational efficiency don’t have to be a conflict for your organization. By bringing agility, automation, and mass customization to your day-to-day processes, you can empower every staff member to work at the top of their certification and consistently deliver that personal touch when it’s needed most.

Pega’s Care Management and Customer Service applications use an always-on AI brain to sense and respond to member and constituent events, including transitions of care and adherence events. We take the guesswork out of health coaching and medical therapy management, so you can deliver exceptional care while driving adherence and cost savings, too.

Streamline Provider Management

A simple solution to a complex problem

Your provider network is essential for your organization – but it’s also incredibly complicated. You need a wide range of physicians and providers. You need to make sure all your constituents can access their services. And you need each of them to be enrolled, correctly certified, and up-to-date. Otherwise, you could drive up costs, create extra work, or even disrupt care.

That’s a lot to tackle. But with Pega’s healthcare automation technology, managing volume and complexity is a no-brainer. Orchestrate provider management and streamline back-office processes, including enrollment and certification. Improved speed and accuracy keeps provider data fresh and minimizes collateral damage. In other words, here’s the cure for your provider management headaches.

Healthcare Summit Replay | 3:07

Operational Excellence at United Concordia Dental

Pega helped UCD automate over 90% of their process, driving 85% auto completion of work.

Watch Now
Healthcare Summit Replay | 49:31

Florida Blue's Journey

Hear how Florida Blue is using Pega Robotic Automation to discover, manage, and automate work across all of its claims operations.

Watch Now

Achieve New Levels of Operational Excellence

Automation that gets work done. Period.

To work fast – while staying 100 percent compliant – you need to be unified. Even the newest, most cutting-edge tech won’t boost efficiency if it’s not integrated with your legacy systems. Ultimately, time spent duplicating efforts across internal silos is time that could be spent serving your members and constituents.

Don’t let fragmented processes and tight regulations keep you from modernizing the way you always wanted to. Pega offers the industry’s only unified digital process automation platform, combining robotics, process automation, and case management together in a unified architecture. And we build in powerful decision analytics, so you’ve got everything you need to automate any process while working faster and smarter.

Personalizing engagement for better health outcomes.

Explore featured applications and solutions for government healthcare organizations:

Customer Service for Healthcare

Engage across the healthcare continuum.

Explore

Sales Automation for Healthcare

Enroll more beneficiaries and constituents.

Explore

Pega Care Management

Collaborate and coordinate for improved outcomes.

Explore

Pega Healthcare Claims Automation

Resolve, simplify, and deliver.

Explore

Get Pega for Government Healthcare

Let us show you how Pega can help your organization.