About Us
A Journey of Innovation, Growth, and Commitment to Transforming Healthcare.
Why Work With Agadia?
Built for Complexity. Powered by Intelligence.
A Market Leader
Serving over 100 million covered lives through 55+ health plan & PBM customers across all 50 states and Puerto Rico, with over 13 million Prior Authorizations processed annually across both the Pharmacy & Medical benefit.
HITRUST Certified Solutions
Agadia’s solutions are proudly HITRUST-certified, representing the highest standard in safeguarding patient data and ensuring compliance with rigorous security, privacy, and risk management requirements.
Founder-Led
Agadia is proudly founder-led, with a deeply committed team that includes many employees who have been with us since the company’s earliest days. That continuity has shaped a strong, people-first culture, one rooted in trust, expertise, and shared purpose, as we continue to grow and build lasting partnerships with our customers.
Privately Held & Customer Focused
Agadia proudly offers flexibility, transparency, and tailored solutions, free from the constraints of public or private equity backing.
Agadia Over the Years
Follow the timeline to see where we are today to the milestones that shaped us.
2025
Introduced AI-based clinical criteria automation capabilities to enhance prior authorization decision support.
- Covering over 100 million lives, approximately one-third of the US population
- Integrated with nearly all claims adjudication systems
- Used by over 50 health plans, PBMs, and healthcare organizations across all lines of business and all 50 states.
2024
Launched first of its kind ePA portal for drugs under both the pharmacy and medical benefit for Hubs, Specialty Pharmacies and Drug Manufacturers.
- Processed around 12 million prior authorizations annually under both the pharmacy and medical benefit.
2023
Launched Formulary Benefit Solution, FormularyHub & Grievance Management Solution, GrievancesHub
- Rolled out QuickPA, an enhancement to streamline the PA process, and PAHub Insights, a reporting tool powered by Microsoft Power BI.
2020
Built the industry’s first electronic medical prior authorization (eMPA) API
- Began processing prior authorizations for drugs and procedures under the medical benefit.
2019
Case Study conducted where Agadia helped a health plan client achieve:
- 44% reduction in fax volume.
- 50% decrease in phone volume.
- 20% increase in case volume with fewer FTEs
- 1.43 ROI on implementation
2017
Achieved HITRUST Certification for Agadia’s Solutions
2016
Implemented the Automation of Non-formulary PAs
- Case study conducted where Agadia delivered a 199% IRR in the first year of PAHub implementation for a health plan client.
2014
Launched RxMTM+ and RxSentinel+
- Launched Agadia’s Medication Therapy Management platform, RxMTM+, enabling clinical interventions to improve patient outcomes.
- Launched Agadia’s Part D Star Ratings & Medication Adherence solution, RxSentinel+
2012
Implemented our first ePA integration with a customer
2010
Launched the PromptPA Portal for Providers, Prescribers & Members
2009
Agadia contributed to the draft for the electronic prior authorization (ePA) workflow as part of the NCPDP task group.
- First Medicare implementations with national health plans
2008
First Medicaid and Commercial implementations in PAHub with a national PBM and regional health plan that are still partnering with Agadia today.
2007
Agadia Founded in Parsippany, NJ.
- Introduced PAHub, Agadia’s flagship solution for automating prior authorization workflows.
