Agadia

What happens when AI supports clinical reviewers, not replaces them? Our latest customer success story highlights how ProAct - PBM increased reviewer productivity by up to 40% using PAHub + ClinIntel, helping clinical teams streamline reviews, extract clinical evidence more efficiently, and maintain strong accuracy. Read the full case study to see how ProAct achieved measurable operational results: https://lnkd.in/e6QTdVaW #HealthcareAI #PriorAuthorization #UtilizationManagement #HealthcareIT #HealthPlans #PBM #CaseStudy #Agadia

We're looking forward to attending the WEDI Summer Forum in Chicago on August 10-11! It's always a great opportunity to connect with healthcare leaders, exchange ideas, and discuss the future of healthcare IT, interoperability, and innovation. If you're attending, we'd love to connect. Contact us to schedule time to meet with our on-site team, Tim Capstick, Ross Loomis, and Brandon Noffsinger to learn how Agadia is helping health plans and PBMs streamline utilization management, formulary management, and more. See you in Chicago! #WEDI #WEDISummerForum #HealthcareIT #HealthPlans #PBM #Interoperability #HealthcareInnovation #UtilizationManagement #Agadia

Artificial intelligence is transforming utilization management, but knowing where AI adds value and where human expertise still matters is what separates successful strategies from costly mistakes. In our latest blog, we explore how AI can help health plans and PBMs streamline prior authorization, reduce administrative burden, improve accuracy, and increase capacity, while also highlighting the areas where clinical judgment and oversight remain essential. AI isn't here to replace people. It's here to help teams work smarter. 📖 Read the full blog: https://lnkd.in/emWTc7bC Interested in learning how Agadia is bringing AI-powered automation to utilization management? Schedule a personalized demo and let's talk about how we can help your organization improve efficiency while keeping clinicians at the center of decision-making. #ArtificialIntelligence #HealthcareAI #UtilizationManagement #PriorAuthorization #HealthPlans #PBM #HealthTech #Automation #DigitalHealth #Agadia

How much time is your team spending managing MTM instead of improving it? Disconnected workflows, manual processes, and evolving CMS requirements can make Medication Therapy Management more complex than it needs to be. RxMTM+ helps Health Plans and PBMs streamline the entire MTM lifecycle in one configurable platform. From identifying eligible members and managing CMRs and TMRs to coordinating outreach and maintaining audit-ready documentation, RxMTM+ empowers your team to work more efficiently while supporting better member outcomes. Modernizing your MTM program doesn't have to mean overhauling your operations. It means giving your team the tools they need to automate routine tasks, improve clinical productivity, and stay prepared for what's next. Ready to see RxMTM+ in action? Schedule a personalized demo today: https://lnkd.in/gr-RdecU #MedicationTherapyManagement #MTM #HealthPlans #PBM #HealthcareTechnology #HealthIT #DigitalHealth #ClinicalOperations #CMS #Agadia

Artificial intelligence is transforming utilization management, but knowing where AI adds value and where human expertise still matters is what separates successful strategies from costly mistakes. In our latest blog, we explore how AI can help health plans and PBMs streamline prior authorization, reduce administrative burden, improve accuracy, and increase capacity, while also highlighting the areas where clinical judgment and oversight remain essential. AI isn't here to replace people. It's here to help teams work smarter. 📖 Read the full blog: https://lnkd.in/emWTc7bC Interested in learning how Agadia is bringing AI-powered automation to utilization management? Schedule a personalized demo and let's talk about how we can help your organization improve efficiency while keeping clinicians at the center of decision-making. #ArtificialIntelligence #HealthcareAI #UtilizationManagement #PriorAuthorization #HealthPlans #PBM #HealthTech #Automation #DigitalHealth #Agadia

Excited to be attending the Michigan Association of Health Plans (MAHP) Annual Conference this week and connecting with Michigan's health plan leaders, innovators, and industry partners. At Agadia, we're excited to share how AI, automation, and modern SaaS technology are helping health plans streamline prior authorization, improve provider experiences, and prepare for evolving regulatory requirements. #MAHP #HealthPlans #HealthcareInnovation #PriorAuthorization #Interoperability #AI #ManagedCare #Agadia #PAHub #HealthcareTechnology

We're heading to the MAHP 2026 Annual Conference! From July 21–24, the Agadia team will be in Acme, Michigan, connecting with health plan and PBM leaders and sharing how we're helping organizations modernize utilization management, streamline prior authorization, and improve the member experience. If you'll be attending, be sure to stop by Booth #39 to meet Tim Capstick, Senior Vice President of Sales. We'd love to learn about your organization's priorities, discuss the challenges you're solving today, and explore what's next. See you at Grand Traverse Resort! 📍 Booth #39 📅 July 21–24, 2026 Can't make it to the conference? We'd still love to connect. Reach out to schedule a personalized demo and see how Agadia can help simplify complexity and accelerate smarter decisions. #MAHP2026 #HealthPlans #PBMs #HealthcareIT #PriorAuthorization #UtilizationManagement #HealthTech #PayerInnovation #Agadia #DigitalHealth #HealthcareTechnology

We're heading to the MAHP 2026 Annual Conference! From July 21–24, the Agadia team will be in Acme, Michigan, connecting with health plan and PBM leaders and sharing how we're helping organizations modernize utilization management, streamline prior authorization, and improve the member experience. If you'll be attending, be sure to stop by Booth #39 to meet Tim Capstick, Senior Vice President of Sales. We'd love to learn about your organization's priorities, discuss the challenges you're solving today, and explore what's next. See you at Grand Traverse Resort! 📍 Booth #39 📅 July 21–24, 2026 Can't make it to the conference? We'd still love to connect. Reach out to schedule a personalized demo and see how Agadia can help simplify complexity and accelerate smarter decisions. #MAHP2026 #HealthPlans #PBMs #HealthcareIT #PriorAuthorization #UtilizationManagement #HealthTech #PayerInnovation #Agadia #DigitalHealth #HealthcareTechnology

Are denial rates telling the whole story? Not always. While denial rates have long been a key utilization management metric, they only measure what didn't get approved. They don't reveal how efficiently the right decisions are being made. A more meaningful KPI? First-pass approval rate. When clinically appropriate requests are approved correctly the first time, health plans can: ✔ Improve operational efficiency ✔ Reduce administrative burden ✔ Accelerate access to care ✔ Enhance provider satisfaction ✔ Allow clinical teams to focus on more complex cases The goal isn't simply to reduce denials—it's to increase the number of accurate, timely decisions made on the first review. As prior authorization continues to evolve, organizations should evaluate success based on the quality and efficiency of their decision-making, not just the number of denials. What metrics does your organization prioritize when measuring prior authorization performance? #PriorAuthorization #UtilizationManagement #HealthPlans #HealthcareInnovation #HealthcareAI #PayerTechnology #DigitalHealth #OperationalExcellence

Build or buy? It's one of the most important technology decisions health plans face, but it's also one of the most misunderstood.   When evaluating utilization management software, the conversation shouldn't focus only on cost or speed. The real question is whether your technology can support long-term scalability, interoperability, regulatory change, and the evolving demands of modern UM.   Our latest blog explores the key considerations behind the build vs. buy decision and why the right foundation matters more than ever.   Read the full blog: 🔗 https://lnkd.in/ePm9V4Ad   #HealthcareTechnology #UtilizationManagement #HealthPlans #DigitalHealth #HealthcareInnovation #Interoperability #PriorAuthorization #HealthIT #AIInHealthcare #Agadia