Case Study: Blue Shield of California improves member and agent satisfaction with Pegasystems

Blue Shield of California reimagines the digital healthcare experience

Blue Shield of California, serving more than 4.5 million members, launched its Health Reimagined initiative to address rising healthcare costs and fragmented member experiences. The organization wanted to improve care quality and make healthcare more affordable, while creating a more connected, personalized digital experience for members and agents. It partnered with Pegasystems, using Pega Platform and Pega Customer Decision Hub to support this effort.

Pegasystems helped Blue Shield of California build a connected member experience with multi-channel outreach, workflow automation, and next-best-action recommendations to proactively engage members and close care gaps. The result was improved operational performance, including reduced average handle time, better first-call resolution, and higher agent and member satisfaction.

Blue Shield of California

Deepa Metla

Senior Manager for Customer Engagement Capabilities