Data AnalysisVerified
Reviewed and published by trentmaziarz, July 11, 2026. Discovered and drafted by our automated research pipeline.
During the COVID-19 pandemic, Blue Cross Blue Shield of Massachusetts used an AI algorithm to identify which of its members were at the highest risk of developing serious health conditions if infected with COVID-19, then routed those members to a team of nurse case managers for direct outreach and support.
Details
The company's data and analytics team built a predictive model that analyzed member health data to score COVID-19 risk levels. Members identified as high-risk were then contacted by Blue Cross nurse case managers who provided education and support resources. The company's chief data and analytics officer noted the model was a continuation of its broader use of AI to assist members and said the team planned to continue fine-tuning it.
Products affected
Internal member risk stratification model
Sources & Evidence
Cite this record
Trace Foundation. (2026). Blue Cross Blue Shield of Massachusetts: During the COVID-19 pandemic, Blue Cross Blue Shield of Massachusetts used an AI algorithm to identify which of its members were at the highest risk of developing serious health conditions if infected with COVID-19, then routed those members to a team of nurse case managers for direct outreach and support (data as of 2026-07-11) [Data set record]. AI Trace. https://www.aitrace.org/r/practice/def0f785-ad31-4d9d-8aba-4491b9d1237b. Accessed October 10, 2026.
- Stable link
- https://www.aitrace.org/r/practice/def0f785-ad31-4d9d-8aba-4491b9d1237b
- Data as of
- July 11, 2026
- Last verified
- Not recorded
Other practices by Blue Cross Blue Shield of Massachusetts
ProductivityBlue Cross Blue Shield of Massachusetts tested an AI system called FastPass that automatically processed prior authorization requests for medical procedures, reducing approval times from an average of nine days to less than one day. The pilot ran at New England Baptist Hospital in 2022 in partnership with AI company Olive.ProductivityBlue Cross Blue Shield of Massachusetts uses an intelligent automation program to automate internal business workflows, with the stated goal of freeing up employees' time for more complex work. The company maintains a dedicated Intelligent Automation team and has posted roles for engineers with robotic process automation expertise.Data AnalysisBlue 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.
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