Build the foundation for autonomous AI agents while the workflows are still simple
Picture the payer workflows that consume the most time: prior authorization, coverage determination, payer-to-payer exchange, denial appeals. Long-running, multi-party, regulated. Now picture autonomous agents handling that work, reliably and under full audit, across payer and provider systems.
Almost no one is there yet. Most agentic pilots stall before production, and the organizations that will be positioned to thrive aren't the ones with the most capable agents. They're the ones laying the groundwork now, while the workflows are still relatively simple, because the controls the harder phases depend on have to be built early. Add them after the fact and the cost climbs, usually discovered only once a pilot has already stalled.
The window matters: gen AI adoption in US healthcare doubled to 50% by the end of 2025, per McKinsey, yet nearly two-thirds of organizations have not scaled AI beyond pilots. The advantage will go to those who prepare before the workflows get complicated.
Learnings include:
Almost no one is there yet. Most agentic pilots stall before production, and the organizations that will be positioned to thrive aren't the ones with the most capable agents. They're the ones laying the groundwork now, while the workflows are still relatively simple, because the controls the harder phases depend on have to be built early. Add them after the fact and the cost climbs, usually discovered only once a pilot has already stalled.
The window matters: gen AI adoption in US healthcare doubled to 50% by the end of 2025, per McKinsey, yet nearly two-thirds of organizations have not scaled AI beyond pilots. The advantage will go to those who prepare before the workflows get complicated.
Learnings include:
- Why healthcare workflows are especially well suited to autonomous agents
- What separates agents that reach production from pilots that stall
- The identity, governance and audit controls to build first
- A crawl-walk-run sequence that avoids a costly retrofit
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