A trusted AI strategy for proven healthcare value
Nearly three out of four employers plan to operationalize artificial intelligence (AI) in their benefits within two years.1 Increasingly, HR professionals expect transparent AI usage by health payers to address cost trend, remove complexity and improve employee experiences.
But with so much AI hype, it's tough to find partners with carefully controlled AI deployments that produce meaningful results.
Blue Cross and Blue Shield of Minnesota invests in AI through a values-driven lens.
Our AI experts identify use cases thoughtfully to solve specific market challenges. We ensure solutions align with the key value drivers at the heart of our trusted operating model: better access, transparency and experience. And because these value drivers have been proven to lower the cost of care2 and deliver a preferred experience for members,3 our AI deployments amplify the value we deliver to both employers and members.
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VALUES-DRIVEN AI INVESTMENT
An approach that’s true to Blue — and valuable to you
Hear from Melissa Flicek, Chief Information Officer at Blue Cross, about our values-driven model and scalable strategy to develop AI solutions that propel growth in benefits engagement, enable efficiency and improve member experiences.
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Scalable strategy
Connecting foundational data and strategy to translate vision into solutions
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Disciplined deployment
Solving specific healthcare challenges for you and your employees
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Quality over quantity
Applying AI where it provides real value, with KPIs that are tracked for full transparency
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Industry-leading experts
Providing oversight with clear governance and accountability for every decision
SIMPLIFIED MEMBER NAVIGATION
Closing care gaps by helping members quickly get the answers they need
Blue Care AdvisorSM is a one-stop navigation solution that leverages AI and the largest provider evaluation dataset, Blue Cross Blue Shield Axis® Provider Insights,4 to give employees personalized guidance for actions to close care gaps.
Teams that directly support members use Blue NoteSM and Lumena to document calls, which enables associates to focus on members so members can quickly get the information and care they need.
44%
Of registered members closed a care gap compared to 32% for unregistered members5
$6.5M
Cost avoidance through gap closures for self-insured clients5
54 sec.
Saved per call with Member Experience Advocates through Blue Note6
5 min., 45 sec.
Case Manager work minutes saved per call through Lumena6
PREDICTIVE COST INSIGHTS
Empowering employers with actionable insights
Predictive modeling in our Strategic Performance and Analytics Resource Kit (SPARK) identifies where employers have opportunities to stabilize future cost trends for rising- and high-risk populations based on specific health conditions.
Machine learning and predictive modeling also power our Social Drivers of Health (SDOH) Intelligence tool, which shows the social factors influencing a group’s member population.
These tools empower targeted interventions that mitigate risks and help lower costs.
12
Months of impactable spend forecast6
39
Data sources6
13
Predictive models6
$1,012 PMPY
Average predicted savings through targeted interventions6
NEXT-GENERATION OPERATIONS
Driving agility through automation
We deployed Auth AI to speed up prior authorization reviews and approvals to provide a better experience for members and providers. At Blue Cross, AI is never used to deny claims or prior authorization requests. Oversight and review are provided by industry-leading experts, ensuring clear direction and accountability for every decision.
Payment Integrity AI helps detect emerging coding patterns, shifts in documentation behavior and market-level trends to combat AI coding intensity and rein in costs before they show up as sustained increases.
65%
Qualified prior authorization requests handled by Auth AI7
60%
Prior authorization requests approved within 5 minutes, with 80% approval targeted in 20277
100%
Claims reviewed annually by payment integrity programs8
$424.5M
Estimated savings annually from payment integrity operations8
FUTURE-FOCUSED INNOVATION
Evaluating performance to shape the future
Insights from our current AI deployments help shape what comes next.
By measuring solution performance against clear KPIs, we turn results into actionable data that informs future investments. This feedback loop helps us strengthen existing capabilities and prioritize the most meaningful enhancements to serve you and your employees.
Examples include:
Blue Care Advisor
Adding an AI-driven homepage and enhancing the care navigation interface through conversational AI chat with live-agent escalation
Blue Note
Building in conversational interactive voice response (IVR), adding multi-language voice and aiming for higher self-service containment
SPARK
Enhancing risk modeling with additional predictive features and more frequent model refreshes to expand risk mitigation
Auth AI
Increasing the scope of prior authorization approvals to integrate with more specialty types, accept faxes and summarize behavioral health documentation
Solving key healthcare challenges through impactful innovation
Blue Cross approaches AI investment through a values-driven lens to solve critical healthcare challenges, supported by connected foundational data and a scalable strategy. Every deployment is carefully governed by experts who provide oversight at each stage and measure performance against clear KPIs.
The result is a portfolio of AI and predictive modeling solutions that are purpose-built to lower overall costs, reduce friction, strengthen transparency and achieve key healthcare outcomes that matter most for employers and members.
Check out our AI overview for a snapshot of our approach — and download our white paper for a deeper look at how impactful innovation from Blue Cross creates better employer value focused on delivering total cost of care savings and a preferred member experience. Or contact a Blue Cross representative to learn more.
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Let's work together
Give us a call: 1-877-293-7035 (TTY 711)
Not already working with Blue Cross? Check out our plans and resources for large and small groups.
12026 U.S. AI in Health and Benefits Survey, WTW, April 2026.
2Singleton A, Tilley C, Rachlin S. “Milliman Analysis of Total Cost of Care Benchmarks,” March 2025.
3Market Insights, Blue Cross Brand Strength Measure Survey, Blue Cross Blue Shield Association, 2025.
4Blue Cross Blue Shield Association internal data, March 2025.
5Blue Care Advisor data, 2025.
6Blue Cross and Blue Shield of Minnesota internal data, 2025.
7Blue Cross and Blue Shield of Minnesota internal prior authorization data.
8Blue Cross and Blue Shield of Minnesota claims that undergo payment integrity advanced coding review. Annual gross savings CY2025 (Commercial fully insured and self insured accounts).