PERSPECTIVE

Re-imagining Payer operations - How Agentic AI can help alleviate cost and regulatory pressures

Unlocking a new era of intelligent, adaptive, and autonomous operations to help Payers navigate cost, compliance, and engagement challenges

Discover how leading healthcare Payers are transforming operations with Agentic AI to tackle rising costs, regulatory demands, and member expectations. This paper explores how autonomous, goal-driven AI agents are reshaping claims management, care coordination, utilization reviews, and member outreach—delivering proactive, personalized, and context-aware interactions.

Inside, you will uncover:

How understanding existing limitations helps drive smarter, scalable Payer transformation with Agentic AI
The top 10 Agentic AI use cases revolutionizing Payer workflows
A deep dive into Post-Discharge Health Risk Assessments powered by virtual agents
How Agentic AI enables self-learning, multi-agent collaboration, and real-time adaptability

Whether you are navigating Medicaid funding cuts or striving for better member engagement, this paper offers actionable strategies to future-proof your operations.