About Us
A Journey of Innovation, Growth, and Commitment to Transforming Healthcare.
A journey of innovation, growth, and commitment to healthcare transformation.
Since 2007, Agadia has grown from a founder-led healthcare technology company into a trusted partner for Health Plans, PBMs, and healthcare organizations nationwide. Our story is defined by long-term customer relationships, continuous innovation, and a culture built on loyalty, expertise, and purpose.
Market Leadership
Supporting high-volume utilization management across pharmacy and medical benefit workflows.
Founder-Led
A privately held company shaped by continuity, commitment, and long-term customer focus.
HITRUST Certified
Solutions designed to protect sensitive healthcare data and support rigorous security standards.
Innovation Culture
Built by experienced teams that continue to advance automation, intelligence, and interoperability.
Built for complexity. Powered by intelligence.
Agadia combines deep utilization management expertise with a long-standing culture of customer commitment, security, and product innovation.
A Market Leader
Agadia supports millions of covered lives and processes millions of prior authorizations each year across pharmacy and medical benefit workflows.
HITRUST Certified Solutions
Agadia’s solutions are HITRUST-certified to support the security, privacy, and risk management needs of healthcare organizations.
Founder-Led
Agadia remains founder-led, with many long-tenured employees who helped shape the company from its earliest days.
Privately Held & Customer Focused
Our ownership structure supports flexibility, transparency, and long-term partnership without public or private equity pressure.
The milestones that shaped our path forward.
From the launch of PAHub to advancements in ePA, medical benefit workflows, formulary management, reporting, and AI-enabled automation, Agadia has continued to evolve alongside the needs of the industry.
Introduced AI-based clinical criteria automation capabilities.
- Enhanced prior authorization decision support with new AI-enabled capabilities.
- Continued expansion across health plans, PBMs, and healthcare organizations nationwide.
Launched an ePA portal for drugs under both the pharmacy and medical benefit.
- Supported Hubs, Specialty Pharmacies, and Drug Manufacturers.
- Processed around 12 million prior authorizations annually across pharmacy and medical benefit workflows.
Launched FormularyHub, GrievancesHub, QuickPA, and PAHub Insights.
- Expanded formulary benefit design and grievance management capabilities.
- Rolled out QuickPA and PAHub Insights, a reporting solution powered by Microsoft Power BI.
Built the industry’s first electronic medical prior authorization API.
- Began processing prior authorizations for drugs and procedures under the medical benefit.
Demonstrated measurable prior authorization performance improvements.
- Case study results included reduced fax volume, decreased phone volume, increased case volume, and positive ROI.
Achieved HITRUST Certification for Agadia’s solutions.
- Reinforced Agadia’s commitment to protecting healthcare data and supporting customer compliance.
Implemented automation of non-formulary prior authorizations.
- Case study results showed a 199% first-year IRR in PAHub implementation for a health plan client.
Launched RxMTM+ and RxSentinel+.
- Introduced Medication Therapy Management capabilities to support clinical interventions.
- Launched Part D Star Ratings and medication adherence capabilities.
Implemented the first customer ePA integration.
- Advanced Agadia’s role in electronic prior authorization connectivity.
Launched the PromptPA portal for providers, prescribers, and members.
- Helped improve electronic prior authorization request submission and status access.
Contributed to ePA workflow development through NCPDP task group participation.
- Completed first Medicare implementations with national health plans.
Completed first Medicaid and commercial implementations in PAHub.
- Partnered with a national PBM and regional health plan that continue to partner with Agadia today.
Agadia founded in Parsippany, New Jersey.
- Introduced PAHub, Agadia’s flagship solution for automating prior authorization workflows.
Long-term people. Long-term partnerships. Long-term results.
Agadia’s history is not only a product story. It is a people story — shaped by a deeply committed team, founder-led values, and customer partnerships that have lasted across years of industry change.
- Privately held and customer focused
- Founder-led vision and long-term continuity
- Deep expertise in utilization management operations
- Long-standing customer relationships across health plans and PBMs
- Continued investment in automation, AI, interoperability, and reporting
Built on experience. Focused on what comes next.
Agadia’s history reflects a continued commitment to healthcare technology innovation, operational excellence, and lasting customer partnerships.