Demystifying AI Agents in Healthcare Operations

This podcast episode, titled "The Deep Dive," explores the concept of AI agents and agentic AI in healthcare, contrasting them with traditional AI and automation tools. The hosts discuss how agentic AI can actively connect to systems, interpret data, and automate workflows in areas like claims processing, care coordination, and prior authorizations, ultimately improving efficiency and freeing up human workers for complex tasks. They detail the core functions of AI agents—synthesizing data, supporting decisions, and executing tasks—and explain the underlying framework, emphasizing autonomous intelligence, scalable design, and seamless integration. The hosts also discuss multi-agent systems (MAS), the role of large language models (LLMs) as enablers, and the importance of governance to ensure ethical and responsible use, highlighting practical use cases for both payers and providers and suggesting next steps for organizations interested in adopting agentic AI.