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.

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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

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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.

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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

PRESS RELEASE: Agadia Launches New Healthcare Technology Solution to Shift the Paradigm of Formulary Benefit Management.

Jul 15, 2020 | Formulary Benefit Design

PARSIPPANY, NJ – July 15, 2020 – Agadia, a healthcare management technology company widely known for innovations in Utilization Management software, has announced the expansion of their suite of solutions to include FormularyHub, an RxContinuum SolutionTM, a fully...

Agadia Systems, Inc. Announces Agreement with WellDyne for use of Agadia’s Prior Authorization Solution, PAHub

May 4, 2020 | Electronic Prior Authorization, Prior Authorization

Agadia Systems, Inc. Announces Agreement with WellDyne for use of Agadia’s Prior Authorization Solution, PAHub. PARSIPPANY, N.J. – May 4, 2020- Agadia Systems, Inc. (Agadia), a well-recognized innovator and provider of the utilization management suite of solutions,...

Press Release: Electronic Prior Authorization Case Study by Agadia Results in a 50% Decrease in PA Phone Volume

Jan 13, 2020 | Electronic Prior Authorization, Prior Authorization

PARSIPPANY, N.J., Jan. 13, 2020 /PRNewswire/ -- In today's market, healthcare stakeholders are continually pressured to improve current prior authorization processes by limiting the use of outdated PA channels, such as phone or fax, and instead gravitating towards the...

Rethinking the Prior Authorization Process

Dec 13, 2019 | Prior Authorization

The following article outlines the challenges our industry is facing with respect to Prior Authorization. Agadia's leading solution, PAHub, addresses these challenges to streamline the PA management process and improve patient outcomes for over 40 of the nation's...

Agadia to Present at the Utilization Management: Addressing Crucial Challenges for Health Plans Conference on Sept 26th

Sep 10, 2019 | Conferences & Events, Prior Authorization

Agadia is proud to sponsor this exciting upcoming event, which will explore how and why innovative health plans are remaking prior authorization to be more efficient and effective - leveraging new strategies and the latest technologies to reduce complication and...

Agadia to Exhibit at the Upcoming Connect19 Conference

Sep 3, 2019 | Conferences & Events, Part D Star Ratings

Agadia will be exhibiting at the upcoming Connect19 Conference on September 23-24th in Boston, MA. Join us as we explore ideas to enhance the consumer experience in health care. Don't forget to use promo code AGA100 to save $100 on your registration! [button...