Case Study: CareFirst BlueCross BlueShield achieves 50% faster time-to-market and streamlined product configuration with Pegasystems' Product Composer System (PCS)

CareFirst BlueCross BlueShield - Customer Case Study

CareFirst, the largest healthcare payer in the Mid‑Atlantic serving 3.4 million members, needed to speed product delivery and eliminate redundant configuration work across siloed teams and two systems (claims engine and enterprise benefit system). Regulatory and business changes forced hundreds of manual, one‑by‑one updates, so CareFirst sought a single, flexible repository to standardize products and benefits and ensure consistent member and provider experiences.

CareFirst implemented Pega’s Product Composer System (PCS) to automate and consolidate product and benefit configuration, reuse building blocks, and export configuration data to downstream systems. As a result, the team configured 250 ACA medical products in five weeks, now manages 800+ products in PCS, made PCS the source of record for claims and self‑service portals, and achieved a 50% reduction in update/configuration time and time to market.

CareFirst BlueCross BlueShield

Phaedra Swann

Program Manager