Agadia Blog
Company and Industry News
Democrats Express Concerns About CMS’s Prior Authorization Requirements and the Use of AI-Driven tools
As per an article published last Friday, House Democrats are pressuring the Centers for Medicare & Medicaid Services (CMS) to better evaluate how artificial intelligence is utilized by Medicare Advantage (MA) plans, hoping to prevent eye-catching rates of denial....
Agadia Announces Game Changing Solution for Grievance Management
Agadia is delighted to introduce GrievancesHub - a cutting-edge web-based resolution system engineered to redefine Grievance Management for Health Plans and Pharmacy Benefit Managers (PBMs). Live demos will begin this December. We invite you to schedule a demo and...
The Human Touch in Healthcare Technology: Navigating the AI Revolution
Technological advancements in the Healthcare industry have become synonymous with progress. The surge of AI technology in healthcare is not only revolutionizing patient care but also reshaping how healthcare operations are conducted. While AI is indeed a powerful...
Setting the Course for Success in 2024: Enhancing Medication Therapy Management Programs
As we approach 2024, it's an ideal time to set new goals and strategies for your Medication Therapy Management (MTM) programs. In this blog post, we'll explore key considerations for enhancing your MTM programs to meet the needs of your members, fulfill CMS...
What Is Utilization Management In-House? How Health Plans Benefit
Health plans continually face the challenge of delivering high-quality care while managing costs and ensuring regulatory compliance. One crucial area where they can make a significant impact is in the realm of utilization management programs. It's led many health...
Medication Therapy Management Solution, RxMTM+: Unveiling the Agadia Advantage
Medication Therapy Management (MTM) solutions have become a crucial component of ensuring patient well-being. For Health Plans and Pharmacy Benefit Managers (PBMs), it's not just about offering MTM services; it's about delivering them effectively, efficiently, and...
Enhancing Healthcare Utilization Management: Agadia’s Suite of Comprehensive Solutions for Health Plans and PBMs
In an ever-evolving healthcare landscape, Health Plans and Pharmacy Benefit Managers (PBMs) face the intricate challenge of utilization management efficiency while ensuring optimal care for their members. Agadia, a trusted partner with a decade-long track record,...
How a Prior Authorization Solution Supercharged This PBM’s Efficiency
Pharmacy Benefit Managers (PBMs) play a pivotal role in ensuring access to cost-effective, quality treatments for self-funded employers and their members. One PBM stood out for its commitment to transparency and advanced clinical management, but they faced a challenge...
Transforming Electronic Prior Authorization for Drugs Under the Medical Benefit with Agadia’s eMPA Solution: PAHub
In the ever-evolving landscape of healthcare, streamlining processes while ensuring compliance is crucial to delivering efficient patient care. One significant challenge that has long plagued the healthcare industry is the manual and time-consuming process of...
The Vital Role of Flexibility and Control in Prior Authorization Management
In the dynamic realm of healthcare, striking a balance between providing optimal care for members and maintaining operational efficiency is a constant challenge. For Health Plans and Pharmacy Benefit Managers (PBMs), the ability to exercise flexibility and control in...
