Blue Cross Blue Shield of Massachusetts uses an internal process of conducting 'equity audits' on all its AI-driven programs to check whether those models produce fair outcomes across its nearly 3 million members regardless of race or ethnicity. This practice is described by the company as an ongoing governance activity.

The company's senior vice president of performance measurement and improvement has described the audits as a way to identify and correct unintended algorithmic bias — for example, a model might indicate white patients are sicker than others simply because they use more health care services, not because they actually are. The company's chief data and analytics officer stated that the team works to remove as much bias as possible from its models. This is an internal governance practice applied across Blue Cross's AI-driven programs.