https://github.com/ajhcs/healthcare-agents
51 specialized AI agents for US healthcare administration. MHA-level expertise in revenue cycle, compliance, quality, clinical ops, payer relations, health IT, and more. Modeled after agency-agents.
https://github.com/ajhcs/healthcare-agents
agents-md ai-agents ai-prompts claude-code copilot-instructions cursor-rules healthcare healthcare-administration healthcare-ai healthcare-ai-agent
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51 specialized AI agents for US healthcare administration. MHA-level expertise in revenue cycle, compliance, quality, clinical ops, payer relations, health IT, and more. Modeled after agency-agents.
- Host: GitHub
- URL: https://github.com/ajhcs/healthcare-agents
- Owner: ajhcs
- License: apache-2.0
- Created: 2026-03-19T01:12:35.000Z (3 months ago)
- Default Branch: main
- Last Pushed: 2026-04-09T21:33:31.000Z (2 months ago)
- Last Synced: 2026-04-09T23:14:37.074Z (2 months ago)
- Topics: agents-md, ai-agents, ai-prompts, claude-code, copilot-instructions, cursor-rules, healthcare, healthcare-administration, healthcare-ai, healthcare-ai-agent
- Language: Python
- Size: 2.19 MB
- Stars: 17
- Watchers: 1
- Forks: 2
- Open Issues: 4
-
Metadata Files:
- Readme: README.md
- Contributing: CONTRIBUTING.md
- License: LICENSE
Awesome Lists containing this project
- awesome-claude-code-toolkit - healthcare-agents - level expertise across 10 divisions -- revenue cycle, compliance, quality, clinical ops, payer relations, health IT, and more | (Ecosystem / Quick Setup with cc-safe-setup)
- awesome-medical-ai - healthcare-agents - agents?style=flat-square) | ⭐ C | 51 specialized AI agents for US healthcare administration. MHA-level expertise in revenue cycle, compliance, quality, clinical ops, payer relations, health IT, and more. Modeled after agency-agents. | (Multi-Agent Medical Systems)
README
Healthcare Agents
51 specialist AI agents for US healthcare administration.
Installable prompts and skills for Claude Code, Codex, OpenCode, Cursor, Copilot, and other agentic coding tools.
51
healthcare specialists
10
administrative domains
95.50
avg final-pass score
Routing + SKILL.md
usable agent formats
Healthcare Agents is a model-agnostic prompt library for healthcare administration work: revenue cycle, quality and compliance, clinical operations, payer relations, health IT, population health, pharmacy programs, operations, strategy, and emergency preparedness.
Each agent is a long-form Markdown specialist with YAML frontmatter, role-specific source awareness, compliance boundaries, operational workflows, concrete deliverable templates, best-input guidance, output modes, and cross-agent handoff rules. The pack installs into tools that support subagents, custom instructions, repository rules, or `SKILL.md` folders.
## TL;DR
| You need | Healthcare Agents gives you |
|---|---|
| Healthcare-specific agent behavior | 51 narrow specialists instead of one generic "healthcare assistant." |
| Easier agent selection | Task-based chooser docs, starter prompts, output modes, and handoff maps. |
| Practical administrative output | Appeal packets, audit binders, gap analyses, dashboards, charters, payer matrices, readiness plans, and workflow checklists. |
| Better regulatory handling | Role-aware references to HIPAA, CMS, OIG, HEDIS, Stars, MIPS/QPP, HRSA 340B, NHSN, TEFCA, HL7/FHIR, X12, and other domain sources. |
| Portable installation | Claude Code agents, Claude/OpenCode skills, Codex agent prompts, Cursor/Windsurf/Copilot rules, Aider context, and plain Markdown. |
| Prompt quality controls | An included self-improvement kit with a frozen rubric, role baselines, scorer guidance, and append-only eval results. |
These agents are for healthcare administration support. They are not clinicians, attorneys, auditors, coders of record, billing authorities, or a safe PHI-processing environment.
## Install
Fast path:
```bash
curl -fsSL https://raw.githubusercontent.com/ajhcs/healthcare-agents/main/install.sh | bash
```
GitHub-backed `npx`:
```bash
npx --yes github:ajhcs/healthcare-agents install
```
The package metadata is ready for npm, but the package is not currently published to the npm registry from this environment. Use the GitHub-backed `npx` command above.
Target a specific tool:
| Runtime | Command |
|---|---|
| Claude Code subagents | `npx --yes github:ajhcs/healthcare-agents install --claude` |
| Claude Skills, Claude Desktop, Claude Cowork | `npx --yes github:ajhcs/healthcare-agents install --claude-skills` |
| Codex CLI / Codex App | `npx --yes github:ajhcs/healthcare-agents install --codex` |
| OpenCode skills | `npx --yes github:ajhcs/healthcare-agents install --opencode` |
| Open Agent Skills convention | `npx --yes github:ajhcs/healthcare-agents install --agent-skills` |
| Cursor rules | `npx --yes github:ajhcs/healthcare-agents install --cursor` |
| Windsurf rules | `npx --yes github:ajhcs/healthcare-agents install --windsurf` |
| GitHub Copilot instructions | `npx --yes github:ajhcs/healthcare-agents install --copilot` |
| All known targets | `npx --yes github:ajhcs/healthcare-agents install --all` |
Preview before writing files:
```bash
npx --yes github:ajhcs/healthcare-agents install --all --dry-run
```
Update existing installs:
```bash
npx --yes github:ajhcs/healthcare-agents install --all --force
```
Uninstall:
```bash
npx --yes github:ajhcs/healthcare-agents uninstall --all
```
## Choose the Right Agent
Start with the task, not the agent name. Use the [agent selection guide](docs/usage/agent-selection-guide.md) when you know the operational problem, the [starter prompts](docs/usage/starter-prompts.md) when you want copy-ready examples, and the [handoff map](docs/usage/handoff-map.md) when the request spans departments.
Every agent now supports four output modes:
| Ask for | When to use it |
|---|---|
| `quick triage` | Symptoms, weak data, or first-pass root cause analysis |
| `workplan` | Owners, sequence, dependencies, KPIs, and timeline |
| `audit/checklist` | Evidence requests, pass/fail criteria, remediation owners |
| `artifact/template` | A draft work product with assumptions and placeholders |
Common starting points:
| You need | Start with |
|---|---|
| Clean claim or denial problem | `revenue-cycle-specialist` |
| Survey readiness | `quality-accreditation-specialist` |
| Prior authorization delays | `clinical-prior-authorization-specialist` |
| ED boarding or capacity issue | `operations-hospital-administrator` |
| Interface or FHIR issue | `healthit-interoperability-engineer` |
| Value-based care performance | `payer-value-based-care-manager` |
| Safety event or RCA | `quality-patient-safety-officer` |
| CHNA or community benefit | `pophealth-community-health-coordinator` |
## Quick Examples
Claude Code:
```text
Use the revenue-cycle-specialist agent in quick triage mode to diagnose why our clean claim rate dropped, then list coding, contract, and prior authorization handoffs.
```
Codex:
```text
Read the quality-compliance-officer healthcare agent and use audit/checklist mode to draft a HIPAA Security Rule evidence checklist for a small clinic.
```
OpenCode:
```text
Use the revenue-contract-analyst skill to model payer contract underpayment risk from a sample allowed-amount table.
```
Rules-based tools:
```text
Using the healthit-interoperability-engineer instructions, review this HL7v2 interface mapping for common ADT and ORU risks.
```
Manual project install:
```bash
git clone https://github.com/ajhcs/healthcare-agents.git
mkdir -p .claude/agents
cp healthcare-agents/agents/*.md .claude/agents/
```
## Why Use This
| Generic healthcare prompting | Healthcare Agents |
|---|---|
| "Follow HIPAA." | Separates Privacy Rule, Security Rule, Breach Notification, minimum necessary, BAAs, operational evidence, and escalation boundaries. |
| "Improve revenue." | Uses CARC/RARC, 837/835, charge capture, CDM, denial prevention, payer contracts, 340B, coding, and cost-report mechanics. |
| "Check quality." | Distinguishes HEDIS, MIPS/QPP, Stars, CAHPS/HCAHPS, accreditation, patient safety, infection prevention, and QI methodology. |
| "Analyze healthcare data." | Names FHIR, HL7v2, X12, C-CDA, Epic Caboodle/Cogito, USCDI, TEFCA, eCQMs, registries, and data-lineage controls. |
| "Make an operational plan." | Produces healthcare-specific work products: appeal packets, readiness binders, staffing models, audit trails, gap analyses, and KPI dashboards. |
## Supported Tools
```mermaid
flowchart LR
A["agents/*.md
source prompts"] --> B["Claude Code
~/.claude/agents"]
A --> C["Codex
~/.codex/agents + AGENTS.md"]
A --> D["Rules folders
Cursor · Windsurf · Copilot"]
A --> E["Generated SKILL.md"]
E --> F["Claude Skills
Desktop · Cowork"]
E --> G["OpenCode Skills"]
E --> H["Open Agent Skills
.agents/skills"]
```
| Tool / Standard | Install Target | Notes |
|---|---|---|
| Claude Code subagents | `~/.claude/agents/*.md` | Source prompts use lowercase hyphen `name` values matching filenames. |
| Claude Skills | `~/.claude/skills//SKILL.md` | Generated skill wrappers include `name`, `description`, `license`, and `compatibility`. |
| Claude Desktop / Claude Cowork | Claude-compatible skills | Use `--claude-desktop`, `--claude-cowork`, or `--claude-skills`. |
| Codex CLI / Codex App | `~/.codex/agents/*.md` plus `~/.codex/AGENTS.md` | Installer adds a managed discovery block telling Codex how to choose specialists, use output modes, and name handoffs. |
| OpenCode | `~/.config/opencode/skills//SKILL.md` | Matches OpenCode's skill directory conventions. |
| Open Agent Skills | `~/.agents/skills//SKILL.md` | Portable fallback for tools that scan a common `.agents/skills` layout. |
| Cursor | `.cursor/rules/*.md` | Installs the same Markdown prompts as project rules. |
| Windsurf | `.windsurf/rules/*.md` | Installs the same Markdown prompts as project rules. |
| GitHub Copilot | `.github/instructions/*.md` | Rename to `.instructions.md` if your Copilot setup requires that extension. |
| Gemini CLI | `~/.gemini/agents/*.md` | Installs Markdown agent files globally. |
| Cline | `.clinerules/*.md` | Installs prompt files into project rules. |
| Amazon Q Developer | `.amazonq/rules/*.md` | Installs prompt files into project rules. |
| Continue.dev | `.continue/*.md` | Installs prompts as reusable context files. |
| Aider | `.aider.conf.yml` managed `read:` block | Adds all agent prompts as read-only context entries. |
## Agent Catalog
Strategy & Advisory - 5 agents
| Agent | Specialty |
|---|---|
| `strategy-healthcare-consultant` | Service line planning, M&A, market analysis, CON strategy |
| `strategy-operations-consultant` | Lean/Six Sigma, throughput, benchmarking, predictive operations |
| `strategy-clinical-operations-consultant` | Clinical workflows, staffing models, ED/OR throughput |
| `strategy-structural-improvement-consultant` | Org redesign, governance, change management, post-merger integration |
| `strategy-actuarial-advisor` | Risk adjustment, capitation, IBNR, MLR, actuarial caveats |
Clinical Operations - 8 agents
| Agent | Specialty |
|---|---|
| `clinical-utilization-management-specialist` | Medical necessity, status, notices, InterQual/MCG boundaries |
| `clinical-care-management-specialist` | Care coordination, TCM/CCM, readmission prevention, SDOH |
| `clinical-research-coordinator` | IRB, ICH-GCP E6(R3), 21 CFR Part 11, trial operations |
| `clinical-documentation-improvement-specialist` | CDI queries, CC/MCC capture, DRG optimization |
| `clinical-prior-authorization-specialist` | PA workflows, appeals, ePA, payer/state variation |
| `clinical-referral-specialist` | Referral management, network navigation, care gap closure |
| `clinical-case-manager` | Discharge planning, post-acute placement, LOS optimization |
| `clinical-infection-prevention-specialist` | NHSN, HAI surveillance, stewardship, outbreak response |
Quality, Safety & Compliance - 7 agents
| Agent | Specialty |
|---|---|
| `quality-improvement-specialist` | HEDIS, MIPS/QPP, Stars, eCQMs, SPC, Baldrige |
| `quality-process-improvement-analyst` | PDSA, Lean, Six Sigma DMAIC, capability/takt math |
| `quality-patient-experience-coordinator` | CAHPS/HCAHPS, service recovery, grievance escalation |
| `quality-patient-safety-officer` | Sentinel events, RCA2, HFMEA, Just Culture, PSO boundaries |
| `quality-compliance-officer` | HIPAA, Stark, AKS, FCA, OIG, EMTALA, CIA evidence |
| `quality-risk-manager` | ERM, malpractice, claims, CRP, NPDB/state reporting boundaries |
| `quality-accreditation-specialist` | TJC, NCQA, URAC, AAAHC, DNV, survey readiness |
Revenue Cycle & Finance - 6 agents
| Agent | Specialty |
|---|---|
| `revenue-cycle-specialist` | End-to-end RCM, denials, EDI, A/R, patient financial experience |
| `revenue-finance-manager` | Budgets, reserves, CMS-2552, cost accounting, margin analysis |
| `revenue-contract-analyst` | Payer contracts, fee schedules, reimbursement modeling |
| `revenue-medical-coding-specialist` | ICD-10-CM/PCS, CPT, DRG, HCC, E/M, appeals |
| `revenue-340b-program-manager` | Covered entity compliance, contract pharmacy, split billing, HRSA audits |
| `revenue-chargemaster-analyst` | CDM maintenance, price transparency, charge capture integrity |
Payer & Managed Care - 6 agents
| Agent | Specialty |
|---|---|
| `payer-value-based-care-manager` | ACOs, shared savings, attribution, downside-risk readiness |
| `payer-relations-specialist` | Network development, contract negotiation, No Surprises Act |
| `payer-medicare-medicaid-specialist` | CMS regulations, CoPs, MAC requirements, dual-eligible programs |
| `payer-managed-care-analyst` | Capitation, MLR, PMPM, network adequacy |
| `payer-credentialing-enrollment-coordinator` | CAQH, PECOS, CMS-855, delegated credentialing |
| `payer-medicare-outreach-coordinator` | Beneficiary education, enrollment periods, LIS/Extra Help |
Health IT & Informatics - 6 agents
| Agent | Specialty |
|---|---|
| `healthit-informatics-manager` | Clinical informatics, USCDI/TEFCA, ONC HTI-1, data governance |
| `healthit-epic-applications-analyst` | Epic build/config, Bridges, Caboodle/Cogito |
| `healthit-information-manager` | HIM operations, ROI, record retention, legal health record |
| `healthit-clinical-data-analyst` | Registries, eCQMs, MIPS, SQL/Python healthcare analytics |
| `healthit-interoperability-engineer` | HL7v2, FHIR R4, C-CDA, X12 EDI, HIE connectivity |
| `healthit-telehealth-program-manager` | Virtual care ops, licensure, RPM/RTM, payer policy matrices |
Operations & Administration - 7 agents
| Agent | Specialty |
|---|---|
| `operations-hospital-administrator` | Bed management, capacity planning, throughput |
| `operations-physician-practice-manager` | wRVU compensation, MGMA benchmarking, practice operations |
| `operations-ambulatory-manager` | Clinic workflows, scheduling optimization, patient access |
| `operations-home-health-administrator` | CoPs, OASIS, PDGM, home health VBP |
| `operations-long-term-care-administrator` | SNF CoPs, MDS, PDPM, Five-Star, PBJ |
| `operations-supply-chain-manager` | GPOs, value analysis, OR supplies, recalls |
| `operations-workforce-manager` | Staffing models, scheduling, retention, workforce analytics |
Population Health & Community - 3 agents
| Agent | Specialty |
|---|---|
| `pophealth-population-health-manager` | Risk stratification, care gaps, SDOH, chronic disease programs |
| `pophealth-surveillance-coordinator` | Reportable diseases, outbreak investigation, syndromic surveillance |
| `pophealth-community-health-coordinator` | CHNA, Schedule H, health equity, CHW programs, grants |
Pharmacy & Drug Programs - 2 agents
| Agent | Specialty |
|---|---|
| `pharmacy-benefits-specialist` | Formulary, PBM contracts, specialty pharmacy, biosimilars |
| `pharmacy-medication-safety-specialist` | ISMP, LASA drugs, CPOE, BCMA, USP 797/800 |
Emergency & Preparedness - 1 agent
| Agent | Specialty |
|---|---|
| `emergency-preparedness-coordinator` | HICS, CMS EP CoPs, surge planning, HVA |
## Eval Status
All 51 agents have been improved through the repository's lightweight self-improvement loop.
| Pass | Agents | Average Before | Average After | Delta |
|---|---:|---:|---:|---:|
| First before/after pass | 15 | 85.0 | 93.9 | +8.9 |
| Remaining before/after pass | 36 | 85.11 | 95.50 | +10.40 |
The eval kit is intentionally simple and auditable:
| File | Purpose |
|---|---|
| `.claude/commands/eval.md` | Canonical workflow for Claude Code and Codex. |
| `eval/rubric.md` | Frozen scoring rubric. |
| `eval/role-baselines/` | Expected-capability baselines for all 51 agents. |
| `eval/results.tsv` | Append-only results log. |
| `docs/eval/exam-architect-playbook.md` | Guidance for question writing and scoring behavior. |
| `docs/eval/model-tuning.md` | Model-role routing notes for current SOTA models. |
| `eval/run-logs/` | Local ignored artifacts for exact questions, scorer outputs, editor briefs, and summaries. |
Same-question before/after comparisons must preserve full Q001-Q025 artifacts before answers are generated. This keeps score deltas tied to the exact same exam rather than paraphrased weak areas.
## Self-Improvement Kit
Install the eval loop into another project that already has `agents/*.md`:
```bash
git clone https://github.com/ajhcs/healthcare-agents.git
bash healthcare-agents/scripts/install-self-improvement-kit.sh /path/to/project
```
Run in Claude Code:
```text
/eval revenue-medical-coding-specialist
```
Run in Codex:
```text
Run the healthcare self-improvement loop for revenue-medical-coding-specialist.
```
During a normal eval run, only the requested `agents/.md` file should change, `eval/results.tsv` should only receive appended rows, and local artifacts should stay under ignored `eval/run-logs/` paths.
## Repository Layout
```text
.
├── agents/ # 51 source agent prompts
├── .claude/commands/eval.md # canonical self-improvement workflow
├── eval/
│ ├── rubric.md # frozen scoring rubric
│ ├── results.tsv # append-only eval log
│ ├── role-baselines/ # expected capability baselines
│ └── run-logs/ # local ignored exact-question artifacts
├── docs/eval/ # scorer and model-routing guidance
├── docs/usage/ # agent chooser, starter prompts, handoff map
├── bin/cli.js # GitHub-backed npx entrypoint
├── install.sh # multi-tool installer
└── scripts/ # lint and self-improvement kit helpers
```
## Validation
Validate agent prompt structure:
```bash
bash scripts/lint-agents.sh
```
Preview installer behavior:
```bash
bash install.sh --all --dry-run
```
Check CLI help:
```bash
npx --yes github:ajhcs/healthcare-agents --help
```
## Limitations
- The agents provide healthcare administration support, not final clinical, legal, coding, billing, audit, or compliance determinations.
- Regulations, code sets, payer policies, accreditation standards, and program manuals change. Verify against current primary sources before operational use.
- The prompts do not make an AI tool HIPAA-compliant and do not create a safe PHI-processing environment. Use approved privacy, security, de-identification, and vendor-review workflows.
- Tool support differs by runtime. The installer uses best-known current file layouts and keeps plain Markdown as the fallback.
- The eval scores measure performance against this repository's rubric and role baselines; they are not external certification.
## Troubleshooting
| Problem | Fix |
|---|---|
| `npx healthcare-agents` cannot find the package | Use `npx --yes github:ajhcs/healthcare-agents install`; the npm package is not published yet. |
| Existing files are skipped | Re-run with `--force` after reviewing `--dry-run` output. |
| Your tool does not auto-discover the agents | Install to a custom path with `--path ` or copy the relevant `agents/.md` file into the tool's documented rule/context folder. |
| Claude/OpenCode rejects a skill name | Use v1.1.1 or newer; agent and skill names are lowercase hyphen slugs. |
| You only want one agent | Copy the specific `agents/.md` file or generated `SKILL.md` folder manually. The installer is pack-oriented. |
## FAQ
### Are these Claude Code agents or skills?
Both. The source files in `agents/*.md` install as Claude Code subagents. The installer can also generate one `SKILL.md` folder per agent for Claude Skills, Claude Desktop/Cowork where skills are available, OpenCode, and the open `.agents/skills` convention.
### Do these work in Codex?
Yes. The installer copies prompts to `~/.codex/agents` and writes a managed `~/.codex/AGENTS.md` block telling Codex how to select and read specialists. For repo-local Codex App work, keep the prompts in the repository and reference them from `AGENTS.md`.
### Why did the frontmatter names change?
Claude Code and OpenCode expect lowercase hyphen identifiers. v1.1.1 and newer keep human labels in `display_name` while making `name` match the filename slug.
### Can I use these for HIPAA, coding, payer, or compliance work?
Use them for structured analysis, checklists, source-aware workflows, and draft deliverables. Do not treat them as final legal, clinical, coding, billing, audit, or compliance determinations.
### Can I use these with PHI?
Only inside an environment your organization has approved for PHI, with the right vendor agreements, access controls, retention settings, and de-identification practices. The prompts themselves do not solve that governance problem.
### Can I add my own agents?
Yes. Follow the conventions in [CONTRIBUTING.md](CONTRIBUTING.md), run `bash scripts/lint-agents.sh`, and keep the agent narrow, source-aware, and operationally concrete.
## License
Apache 2.0. See [LICENSE](LICENSE).