Health Net Picks Pegasystems to Achieve New Value and Efficiencies Across Its Operations

SOURCE: Pegasystems

Pegasystems Inc. , the leader in business process management (BPM), today announced that Health Net, Inc. has chosen Pegasystems to help achieve new value and efficiencies across its operations.  Pega’s advanced healthcare solutions for claims, care management and customer service allow customers to realize controlled and rapid transformation in step with the demands of healthcare reform.

A Fortune 150 company, Health Net’s health plans and government contracts subsidiaries provide health benefits to approximately 6 million individuals across the country through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs.

Pega’s solutions provide the opportunity for health plans and other healthcare-related businesses to address major changes anticipated in the healthcare industry, including increased regulation and the potential addition of 26 million new Medicaid and Medicare members.  Pegasystems’ Build for Change^® technology delivers rapid deployment and increased flexibility without compromising rich “out-of-the-box” functionality, so healthcare organizations can leverage existing investments and streamline operations in a controlled manner.  These organizations achieve faster innovation and new efficiencies while also benefiting from lower total cost of ownership.

Pega’s solutions are widely used by major healthcare organizations including six of the eight largest US health plans, two of the four largest pharmacy benefit managers, several leading healthcare delivery systems, and US government agencies at the state and federal level.  Healthcare transactions for more than one of every two Americans, including members from over 60 percent of the Blues network, are processed with Pegasystems’ technology.

Supporting Quotes:

Janice Young, Program Director, IDC Health Insights

“New vendor solutions in the healthcare payer market are emerging that provide broader technology management options other than the traditional application ‘rip and replace’ model.  Well-timed in this era of multiple and competing business and technology priorities, financial constraints, legislative mandates, and risk mitigation, these technology models enable healthcare payers to leverage legacy investments and move incrementally and iteratively toward newer architectures.  These solutions will be critical to enabling healthcare payers and their technology partners to respond to the demands of the reforming market amid severe cost pressures.”

Elizabeth Hart, Principal, Healthcare Industry Solutions, Pegasystems:

“The pace of change and magnitude of disruption brought on by healthcare reform makes Pega’s Build for Change technology the ideal solution for organizations needing to manage their transition to next-generation healthcare.  Pega’s comprehensive healthcare solutions create a powerful and extensible foundation that can be leveraged to speed health plans’ transformative efforts.”

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