Rethinking the Prior Authorization Process

Navigating Opioid and Controlled Substance Programs in Healthcare

by Karen Apwah | Dec 4, 2023 | Adherence, Opioid Overutilization

Addressing the opioid epidemic requires more than just awareness—it demands strategic and efficient solutions. Health Plans and PBMs play a crucial role in curbing this crisis, and Agadia's RxSentinel+ is at the forefront, empowering organizations to configure and...

Empowering Health Plans and PBMs to Address the Prior Authorization Burden: Insights from Medical Groups

by Karen Apwah | Nov 21, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

In response to the recent report from the Medical Group Management Association (MGMA), it's evident that the prior authorization process remains a significant challenge for medical groups, impacting patient care and straining operational efficiency. The report...

Optimizing Electronic Medical Prior Authorizations: The Transformative Power of PAHub

by Karen Apwah | Nov 15, 2023 | Electronic Prior Authorization, ePrescribing, Prior Authorization

Efficiently processing medical prior authorizations is crucial for Health Plans and Pharmacy Benefit Managers (PBMs) seeking to enhance operational efficiency and improve patient outcomes. In this blog post, we'll explore the importance of streamlined eMPA workflows...

Democrats Express Concerns About CMS’s Prior Authorization Requirements and the Use of AI-Driven tools

by Karen Apwah | Nov 7, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

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

by Karen Apwah | Nov 6, 2023 | 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

by Karen Apwah | Oct 30, 2023 | Healthcare Technology

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

by Karen Apwah | Oct 24, 2023 | Medication Therapy Management

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...

Unlocking Efficiency: The Case for Bringing Utilization Management Programs in House

by Karen Apwah | Oct 18, 2023 | Adherence, Formulary Benefit Design, Medication Therapy Management, Part D Star Ratings, Prior Authorization

Health plans face the constant challenge of providing 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. Traditionally, many health...

Medication Therapy Management Solution, RxMTM+: Unveiling the Agadia Advantage

by Karen Apwah | Oct 11, 2023 | Medication Therapy Management

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

by Karen Apwah | Sep 26, 2023 | Adherence, Formulary Benefit Design, Medication Therapy Management, Part D Star Ratings, Prior Authorization

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,...

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