Transforming Healthcare
with Proven Innovation

Industry-leading utilization management solutions built on decades of expertise—empowering health plans, PBMs, and healthcare organizations with advanced automation, efficiency, and compliance.

SCHEDULE A DEMO

WHY AGADIA

Next-Gen Utilization Management Solutions:
AI-Powered, Expert-Driven

Pharmacy & Medical Benefit Prior Authorization Technology for Health Plans & PBMs

Electronic Prior Authorization for Hubs, Specialty Pharmacies, & Drug Manufacturers

Part D Star Ratings & Adherence

Health Plan, PBM & TPA Customers

Covering Nearly

Million Lives

Backed By

Years in Business



Why Choose Agadia?

Beyond a Vendor: Your Trusted Business Partner in Healthcare Innovation

We proudly go beyond traditional vendor relationships by continuously investing in the evolution of our solutions. We proactively implement global enhancements driven by new CMS regulations, industry requirements, and emerging technological trends, ensuring our clients stay ahead in an ever-changing healthcare landscape.

Contact Us

Increased Processing Speed by

133%

For Prior Authorizations Using PAHub

Explore How a Health Plan
Specializing in State Medicaid

Doubled Their Prior Authorization Volume

with an actual reduction in staff, and increased their processing speed by more than 133%

Read the Case Study

What our clients are saying

Trusted By Leading Health Plans & PBMs

“Agadia has been pivotal in our go-to-market strategy—both from a product stand-point as well as strategic leadership demonstrated by their team.” — VP, IT

First Year IRR of

199%

While Using PAHub

Learn how a Health Plan with both commercial and medicare business

Saw an Internal Rate of Return of 199%

within one year of using PAHub

Read the Case Study

OUR MISSION

Agadia is dedicated to

improving the quality of care and expediting the delivery of health care services by advancing and automating utilization management processes.

What Our Clients Are Saying

"Agadia has been a fantastic partner for several years. As MedOne has grown as a market leader in medication stewardship, we have directly benefited from the efficiencies afforded through the PAHub platform. We would not have been able to enhance the level of care we provide to our members while scaling our operations without the support of the Agadia software and team." - Dr. Nathan Harold, RPh, PharmD., MedOne

"I wanted to pass along that the CDAG portion of our CMS audit last week went well and complement Agadia on the PAHub systems display. The ease of navigation through the full report helped us display the information very smoothly and precisely which is often half the battle in a CMS audit." - Manager - PBM

"I just wanted to drop a quick note letting you know how well PAHub has worked out for us. It has been instrumental in ensuring compliance with various regulations and increased the overall productivity of the Clinical staff. This is a terrific product that has allowed CMS audit events to go very smoothly. Thank you for helping us be successful!" - A.P.; SVP PBM

"Agadia has consistently lead product development with out-of-the-box thinking focusing on a replicable feature-sets to reduce our overall cost of ownership. Their commitment to project management best practices has allowed us to prioritize tactically and avoid potential budget escalations. Agadia’s growing market foot-print clearly demonstrates their commitment to innovation in the healthcare IT space and have been phenomenal to work with." - VP, PBM

In the News

Streamlining Medication Therapy Management for Health Plans and PBMs

Jul 18, 2023 | Medication Therapy Management

The Importance of Streamlining Medication Therapy Management: In today's complex healthcare landscape, operating an efficient and effective Medication Therapy Management program is a critical aspect of ensuring optimal patient outcomes and reducing healthcare costs....

The Importance of Operational and Compliance Efficiencies in Prior Authorization Management

Jul 10, 2023 | Electronic Prior Authorization, Prior Authorization

Introduction: In today's complex healthcare landscape, Health Plans and Pharmacy Benefit Managers (PBMs) face significant challenges in managing their prior authorization (PA) programs efficiently and ensuring compliance with regulatory requirements. The operational...

Navigating Medicare Program Changes: How PAHub Supports Health Plans and PBMs in Medicare Part D

Jun 27, 2023 | Electronic Prior Authorization, Prior Authorization

Introduction: As the healthcare landscape evolves, it's crucial for Health Plans and Pharmacy Benefit Managers (PBMs) to adapt to changing regulations and optimize their processes. A recent article published in the Federal Register sheds light on the Medicare...

Agadia Systems, Inc. Announces Integration with CQ fluency within Prior Authorization Solution, PAHub.

Sep 7, 2022 | Electronic Prior Authorization, Prior Authorization

Agadia Systems, Inc. Announces Integration with CQ fluency within Prior Authorization Solution, PAHub. PARSIPPANY, N.J. – Sept 7, 2022- Agadia Systems, Inc. (Agadia), a recognized healthcare technology solution provider for over 50 of the nation’s leading...

Electronic Prior Authorization for Drugs Covered Under the Medical Benefit (eMPA)

Mar 25, 2021 | Electronic Prior Authorization, Prior Authorization, Uncategorized

Electronic Prior Authorization for Drugs Covered Under the Medical Benefit From Agadia's White Paper CollectionElectronic Prior Authorization for Drugs Covered Under the Medical BenefitPAHub - An end-to-end electronic PA solutionOver the last several years, the volume...

Agadia Systems, Inc. Announces Agreement with Blue Cross and Blue Shield of Kansas City for use of Agadia’s Electronic Prior Authorization Solution, PAHubTM.

Feb 18, 2021 | Prior Authorization

PARSIPPANY, N.J. – Feb 18, 2021- Agadia Systems, Inc. (Agadia), a recognized healthcare technology solution provider for Health Plans & PBMs is announcing an agreement with Blue Cross and Blue Shield of Kansas City (Blue KC), to utilize PAHub, Agadia’s HITRUST...