The ACR opposes a new Blue Cross Blue Shield of North Carolina (Blue Cross NC) initiative that relies on artificial intelligence (AI) technology and may harm patients’ access to treatment and undermine the doctor-patient relationship.
On July 1, Blue Cross NC introduced its new Autoimmune Pathways Program, which uses a web-based, machine-learning technology platform to make decisions about patients’ care and treatment. The goal of the program is to reduce costs, which would be achieved by delaying the introduction of biologic therapy and encouraging dose tapering and/or “medication holidays” in patients who are in remission or show low disease activity.
The ACR sent a letter to Blue Cross NC expressing opposition to this initiative on the grounds that it jeopardizes patients’ health, interferes with medical decision making and undermines the doctor-patient relationship. The ACR is pursuing a follow-up meeting with Blue Cross NC and its technology vendor to gather additional information and advocate on behalf of rheumatology practices and patients. Additionally, the ACR is developing a position statement on the use of AI in rheumatology and will be engaging policy makers and media on concerns.
For questions regarding this policy or other insurance coverage concerns, contact [email protected].