Pega Care Management For Healthcare

Pega’s Care Management Application helps you transform how you manage costs, coordinate services and improve outcomes, while providing person-centered care. With a unified platform, it manages care administration so you can focus on care delivery, connect care teams, and personalizes programs for better financial, operational and health outcomes.

The application makes it easy to connect with and engage your members, orchestrating care programs across back-end systems and every channel including: web self-service, healthcare devices, mobile applications, and phone calls. Actionable analytics reminds members to choose healthy behaviors and coordinate activities across the care team to deliver the best value care. Leverage packaged capabilities to automatically create activity documentation for compliance and quality management, plus automate referral and authorization requests to improve provider satisfaction, member satisfaction, and health outcomes. With Pega’s Care Management Application you can develop specialized programs rapidly because Pega dynamically creates context-aware, tailored care plans that automatically adjust the standardized plan to fit the situation.

Transcript:

Pega makes it easy to connect with and engage your members, orchestrating care programs across backend systems and channels, including web self-service, healthcare devices, mobile applications, and phone calls. Pega Care Management helps you transform how you manage and coordinate services and improve outcomes, all while providing person-centered care. Pega's unified platform manages care administration so you can focus on care delivery. It automates processes, connects care teams, and personalizes programs for better financial, operational, and health outcomes. Pega makes analytics actionable. It reminds members to choose healthy behaviors and coordinates activities across the care team to deliver the best value care.

Pega utilization management leverages built-in integration with industry standard evidence-based guidelines for medical necessity. Pega automatically creates activity documentation for compliance and quality management and coordinates across the care team, including SLA, managed escalations, medical director reviews and notifications. You can easily automate referral and authorization requests to improve provider satisfaction, member satisfaction and health outcomes. Pega Care Management is built on the Pega Infinity platform, which provides visual tools to enable the business to manage the business. Using Pega's low-code platform, you can develop context-aware, specialized care programs rapidly that automatically adjust the standard plan to fit the member's need. Deployed on the cloud or in your data centers, Pega helps you move between care planning and authorizations for population health and acute care management that improves operational value and performance while helping members improve their health outcomes.