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

May 6, 2019 | Electronic Prior Authorization, Prior Authorization

PARSIPPANY, N.J., and Dubuque, I.A.– May 6th, 2019- Agadia Systems, Inc. (Agadia), noted for its ability to improve the quality of care and deliver innovative utilization management solutions to the nation’s leading Health Plans and PBMs, and MedOne, a national,...

CAQH CORE Urges Industry Collaboration on Prior Authorizations

Aug 1, 2018 | Electronic Prior Authorization, Prior Authorization

As validated in the following article, the healthcare industry's approach to prior authorization is evolving. In parallel, such rapid change results in the need for advanced technology to streamline workflows. Agadia, an innovator in healthcare technology, is...

House Passes Medicare Part D Electronic Prior Authorization Bill

Jun 26, 2018 | Adherence, Electronic Prior Authorization, Medication Therapy Management, Opioid Overutilization, Prior Authorization

Last Tuesday, the House of Representatives unanimously passed legislation requiring healthcare professionals to submit prior authorization requests electronically for drugs covered under Medicare Part D. “This change highlights the importance of maintaining a...

PRESS RELEASE: Agadia Systems, Inc. Announces Agreement with MaxorPlus to Utilize Agadia’s Prior Authorization Solution, PAHub

Jun 25, 2018 | Electronic Prior Authorization, Prior Authorization

PARSIPPANY, N.J. and Amarillo, TX – June 25,2018 - Agadia Systems, Inc. (Agadia), an innovator in electronic prior authorization and MTM solutions, and MaxorPlus, a full service PBM pioneering the use of mobile technology to improve clinical outcomes, have announced...

Agadia’s Solution, PAHub, Takes the Pain out of Prior Authorizations

Mar 26, 2018 | Electronic Prior Authorization, Prior Authorization

As noted in the following article posted on AMJC.com by Kelly Davio, prior authorizations are having a significant negative impact on clinical outcomes and causing a delay in care. This challenge is the driving force behind Agadia's prior authorization...

Addressing the Importance of Medication Adherence and Patient Safety

Feb 28, 2018 | Adherence, Medication Therapy Management, Part D Star Ratings

The importance of Medication Adherence in today's marketplace has grown significantly. The following article substantiates the need to address the challenges around patient safety and appropriate medication use. At Agadia, we are working to help the nation's leading...