Perspectives on the Agentic Healthcare Enterprise

Navigating the Shift from Information Support to Autonomous Execution

The healthcare industry has officially moved past the chatbot era. The past year has encompassed a shift from artificial intelligence focused on static analysis and simple chatbots, to Agentic AI. These tools are not merely passive assistants designed to summarize text; instead think of them as autonomous digital teammates capable of planning, reasoning, and executing complex workflows. For Market Access leaders, this means moving from resources that simply retrieve and analyze data to systems that can investigate and respond, drastically increasing success rates in complex problem-solving across the patient journey.

While we are still in the very early stages of the AI transformation, there is already a wide range of AI implementation underway across the life sciences value chain. From new molecule discovery, to high-precision patient identification in rare disease markets, to maximizing efficiencies in patient discharges¹—the foundations of an AI architecture are being built across the industry.

The market access landscape offers a vast array of opportunities to deploy AI solutions. A key strategic decision is determining which areas to target, and at what scope—especially as companies transition from AI for basic repetitive tasks to agentic solutions. One immediate friction point crying out for automated assistance is Prior Authorization (PA). PAs remain a primary bottleneck in the patient journey, contributing significantly to prescription abandonment and clinician burnout.

A sticking point with multiple stakeholders, each with their own proprietary data platforms, aimed at an increasingly automated decisions and appeals process. How can AI help?

What brand teams can do: Make yours look like theirs

Research from Deloitte in 2026 indicates that 93% of health plans are now leveraging AI to simplify and automate prior authorizations.² Brand teams looking to streamline prescription assistance should consider AI-enabled Patient Support Programs that leverage third-party agents and FHIR-based APIs—a standardized framework (Fast Healthcare Interoperability Resources) for more streamlined exchange of electronic health data. Where these enhancements help data platforms to bridge the gap between providers and payers, the task for manufacturers is to align your brands’ AI infrastructure to the systems your stakeholders are using to navigate it.

Moving from digital pilots to essential infrastructure

This shift is not just about convenience; it is about measurable outcomes. Companies are reconsidering the widespread funding of pilots, and benchmarks for success have become more rigorous following the major ramp-up in spending in 2025. Perhaps due to a more shrewd investment outlook vs other industries, data shows successful healthcare implementations achieved a 3.2x ROI within 14 months.³

Finding efficiencies with AI today will lay the foundation for AI-infused business modeling for the future. Targeting long-standing issues like prior authorization as a first step in new automation can not only unlock wins for brands, it can also serve as a new avenue for customer relations—by fostering additional innovations with health systems and payers.

As with all successful account management efforts: Ensuring your offerings align to what customers care about will position your brands as essential, low-friction partners on the leading edge of AI healthcare solutions.

References

1. Dhar N, Lin S, Candy M, Niazi L, Dencik J. Industries in the AI Era: How 10 Industries Are Harnessing AI to Supercharge Business Opportunities. IBM Institute for Business Value; 2025. https://www.ibm.com/industries-AI-era. Accessed January 14, 2026. 2. Deloitte. AI could help health plans simplify prior auth, comply with regs. January 2026. https://www.deloitte.com/us/en/industries/life-sciences-health-care/blogs/healthcare/ai-could-help-health-plans-simplify-prior-auth-comply-with-regs.html. Accessed January 15, 2026. 3. Vention HealthTech. AI in healthcare 2025: ROI and conversion statistics. https://ventionteams.com/healthtech/ai/statistics. 2025. Accessed January 14, 2026.

Authored By:

DIANE PETRONE, SVP, Strategic Services

SAM RIVERA, SVP, Creative, Copy