Brian Goldstein, Chief Medical Officer, UnitedHealthcare
Brian Goldstein, North Carolina and South Carolina market chief medical officer for UnitedHealthcare’s employer-sponsored insurance, spoke with Invest: about United’s ongoing collaboration with providers and employers in the Carolinas and across the United States. “We are also continuing to strengthen our work across commercial, Medicare Advantage, and Medicaid, with an emphasis on affordability, quality, and partnership at the local level,” Goldstein said.
Looking back over the past year, what developments, changes, or trends have influenced UnitedHealthcare’s approach to care within the Charlotte region?
This past year underscored the importance of staying focused on our mission and on the people we serve. Across UnitedHealthcare, we continue to navigate a complex healthcare environment marked by rising costs, changing employer and consumer needs, and continued pressure on individuals, families, and care providers. In Charlotte and across North Carolina, those dynamics reinforce our focus on improving access, simplifying the healthcare experience, and being good stewards of the resources entrusted to us. We are also continuing to strengthen our work across commercial, Medicare Advantage, and Medicaid, with an emphasis on affordability, quality, and partnership at the local level.
How is North Carolina’s population growth influencing your strategy and partnerships locally?
People of all demographics continue to want to move to North Carolina, including young people and retirees. A growing population gives UnitedHealthcare a lot of opportunity and flexibility. We have been fortunate to have new businesses and people to work with on the local level. We have an excellent healthcare system across the state. We are fortunate to have partners like Atrium, Novant, Duke Health, UNC, ECU, and Wake Forest Baptist.
What does the labor landscape look like, and how is UnitedHealthcare adapting to workforce shortages and talent competition across clinical and non-clinical roles?
We continue to see strong interest from skilled professionals who want to live and work in North Carolina, including in actuarial, analytics, economics, operations, and customer service roles. Additionally, the broader healthcare workforce is evolving, and technology can help reduce administrative burden so employees and clinicians can spend more time on higher-value work. On the clinical side, North Carolina benefits from strong training programs and health systems, and many people who train here choose to stay. Nationally, UnitedHealth Group also continues to support the healthcare workforce through Optum and United Health Foundation investments that help current and future clinicians build skills and credentials. The goal is not to replace the human element of healthcare, but to make it easier for people to do their best work and for patients and members to get the support they need.
What role does AI play in United’s decision-making processes, and how are you balancing efficiency with clinical transparency and trust?
UnitedHealthcare and UnitedHealth Group are committed to using AI responsibly. That means AI solutions must be accurate, secure, explainable, and subject to human oversight. AI does not make coverage decisions, issue adverse clinical determinations, or replace clinical judgment. Instead, it is used as a supportive tool to help members, providers, and employees navigate information more efficiently, surface relevant insights and simplify administrative processes. We maintain trust and accountability through governance, transparency and ongoing review, including multidisciplinary oversight of how AI tools are designed, deployed and monitored.
How is AI improving the member and provider experience in practical, everyday ways?
AI is helping make everyday healthcare interactions simpler and more personalized. For members, tools can help identify in-network providers, surface information about cost and access, and connect people more quickly with the right support. For customer service teams, AI can help summarize relevant information so representatives can respond more efficiently and personally. For providers, digital tools are helping streamline administrative processes, including electronic prior authorization submissions, real-time status tracking, and faster decisions. Prior authorization decisions remain subject to established clinical criteria and human review. UnitedHealthcare has also continued to reduce friction in this area, including eliminating authorization requirements for 30% of services that previously required approval by the end of 2026, expanding efforts to standardize electronic submissions and reducing requirements for many rural care providers.
What is United’s approach to growing a more diverse and future-ready healthcare workforce?
We’re committed to supporting a healthcare workforce that is prepared for the future and reflective of the communities it serves. Through the United Health Foundation, we have a 10-year, $100 million commitment to support 10,000 current and future clinicians by 2033. Since 2022, that effort has supported thousands of scholars across nursing, medicine, mental health, allied health, and other clinical pathways. UnitedHealth Group has also partnered with Goodwill Industries International through the Goodwill Opportunity Accelerator, a multi-year effort that expands access to job training, employment services, and healthcare career pathways in communities across the country. These investments are about widening opportunity, strengthening the workforce pipeline, and helping more people build sustainable careers in healthcare.
How does United view housing and social determinants as part of healthcare delivery?
Health is shaped by more than what happens in a doctor’s office. UnitedHealth Group invests in community-led solutions and partners with local organizations to address needs such as chronic condition management, behavioral health, maternal and child health, nutrition, care access, and housing. The company has invested more than $1 billion in affordable housing across the country, recognizing that stable housing can be an important foundation for better health. In North Carolina, that has included support for housing initiatives such as a project in Monroe designed to improve health and stability for people and families facing housing insecurity. The most effective solutions are often local, so our role is to listen, partner, and help scale what communities know they need most.
What’s your outlook for Medicare Advantage and its role in the future of care delivery, and what regulatory changes have made an impact?
Medicare Advantage remains an important option for many older adults because it can offer coordinated care, supplemental benefits, and predictable support beyond traditional Medicare. The regulatory and funding environment also continues to evolve, and sustainability matters for members, providers, and taxpayers. Our focus is on offering Medicare Advantage in a way that supports access, quality, affordability, and long-term stability. Each year, we evaluate markets carefully and work to ensure the benefits and networks we offer are responsible, competitive, and aligned with the needs of the people we serve.
How are your value-based care partnerships evolving to reflect changing care models?
Value-based care continues to grow slowly but meaningfully. We partner with health systems, physician practices, home care agencies, and skilled nursing organizations around shared goals: better outcomes, better experiences, and more efficient care. These partnerships work best when incentives are aligned and when both sides have a stake in quality and affordability. Quality measurement has also become more sophisticated, including through organizations such as the National Committee for Quality Assurance, and that helps us evaluate whether care models are delivering the outcomes we expect. As new forms of care continue to grow, such as hospital-at-home and virtual care, we need measures that capture the right data and reflect the quality of care being delivered in different settings.
What are your top priorities in improving both employer and member experiences in Charlotte?
In Charlotte, our top priorities are to make healthcare simpler, more affordable, and easier to navigate for employers and members. That means continuing to strengthen partnerships with health systems and independent practices, investing in digital tools that help people understand their benefits and find care, and offering employers products that give people clearer information about cost and access. The UHC Store is one example of how we are bringing health and wellness products, fitness and nutrition offerings, planning resources, and community supports into a more convenient experience. We are also continuing to offer options such as Surest, a copay-only plan designed to give members clearer, real-time information about provider cost and access. At the highest level, we want to be a trusted partner in this market — supporting employers, helping members make more informed decisions, and being good stewards of the resources entrusted to us.
