Pega Care Management Application
"Going forward, Pega is like our conductor. It's the orchestrator of our systems."
Get to know Pega Care Management Application
Bring data to life with
personalized care plans
personalized care 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
clinical guidelines
Pega promotes best practices to help lower costs and improve health outcomes. Certified integrations with MCG and Optum/Change Healthcare, 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, clinical, along with embedded GenAI coaching, providing opportunities to promote population health programs.
Reduce gaps in care with
health risk assessments
health risk assessments
Drive a system of coordinated heath care assessments, interventions, and communications for defined patient populations. Leverage advanced AI for next best action to identify and support personalized self-care efforts to produce quality outcomes, all while boosting organizational HEDIS and Star scores.
Adapt and comply with
on premises or on cloud
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.
Reports provide insights for organizations see opportunities to improve operational excellence.
Pega simplifies sending educational materials and letters for health and wellness programs.
Connect the internet of medical devices with care teams so abnormal value alerts become actionable.
Automate intelligent appeals, grievances, and complaints management.
Everything from standard federal program assessments to short, actionable pain assessments included.
Business users can configure their own reports to see exactly the data they want and need.
Customer Decision Hub, Integrated
Direct integration with Pega’s Customer Decision Hub to predict customer needs, personalize every interaction, and deliver across channels.
Built on Customer Service for Healthcare
Leveraging top-rated customer service, Pega Care Management is not just integrated with, it is designed and built on top of Pega’s Customer Service for Healthcare.