The growing number of patients taking GLP-1 medications has coincided with declining obesity rates, but the drugs may increase health care costs.
Artificial intelligence is helping insurers analyze costly claims and guide patients through an increasingly complicated system. And where a patient receives care can make a significant difference in what that care ultimately costs.
Those tensions took center stage Sept. 3 as Michael Wahlstrom, CEO of UnitedHealthcare’s Georgia and Alabama Employer & Individual Health Plan, and Dr. Stephen Palte, chief medical officer, spoke with Atlanta business leaders at Atlanta Trend’s CEO Leadership Luncheon at The Capital Grille in Dunwoody. During the discussion, “The New Affordability Challenge,” they examined what is driving health care costs, how UnitedHealthcare is responding and how consumers and employers can navigate a system being reshaped by new technologies and treatments.
“Cost just continues to escalate,” Wahlstrom said.
UnitedHealthcare saw a 12 percent increase in claims exceeding $100,000 from 2024 to 2025, Wahlstrom said. He pointed to hospital prices and increasingly frequent and severe catastrophic claims, while cancer-related therapies continue to grow more expensive. Emergency room and urgent care use is also increasing, especially among younger patients, as use of less expensive virtual care declines.
For Atlanta consumers, Wahlstrom and Palte identified higher hospital prices, specialty medications and complex chronic conditions as major cost drivers. Medical innovations are improving and extending lives, they said in responses provided after the luncheon, but those advances are also creating affordability challenges for families and employers.
Hospital consolidation adds another layer. In Georgia, consolidation can help health systems expand services and coordinate care, but reduced competition can also increase costs that may eventually reach consumers through higher premiums, deductibles and out-of-pocket expenses, Wahlstrom and Palte said.
So, what can consumers do?
One answer may already be on their phones.
“What we see is people that are engaged…using the app or using the desktop features,” Wahlstrom said.
Consumers can use insurer apps and online tools to understand benefits, search for providers and compare care options. Wahlstrom said members who engage with those tools tend to become more involved in health care decision-making, which “leads to lower overall costs.”
UnitedHealthcare also directs members toward what it calls higher-efficiency providers. That does not simply mean the least expensive doctor. Wahlstrom and Palte said the company considers quality, outcomes, patient experience and affordability when identifying high-value providers. Palte also pointed to ambulatory surgery centers, where certain procedures can cost less than at hospital outpatient facilities.
AI is increasingly part of that strategy.
UnitedHealthcare is using AI and data to examine high-cost cases and payment disputes. For patients, this can help identify payment inaccuracies, explain coverage, provide personalized guidance and identify opportunities for earlier intervention. They emphasized that clinical decisions remain with health care professionals.
But another innovation presents a more complicated cost equation: GLP-1 medications, the class of drugs that includes Ozempic.
Significant weight loss could potentially reduce obesity-related complications, but Palte said UnitedHealthcare is seeing higher costs in the short term. Some employers covering GLP-1s for obesity saw a “huge increase” in pharmacy spending, while UnitedHealthcare found higher spending among members taking the drugs, including costs tied to emergency care, gallbladder disease, nausea and vomiting.
“In the short term, we are actually seeing increased spend,” Palte said.
“Whether that changes over time remains unanswered”, Palte said potential benefits could take “10, 15, 20 years” to emerge, meaning an employer paying for the medication today might not be the organization that eventually benefits from lower medical costs. He emphasized the importance of pairing GLP-1 treatment with lifestyle changes.
The luncheon also touched on the No Surprises Act, which protects patients from certain unexpected out-of-network bills. While patients are generally protected from direct involvement in payment disputes between insurers and providers, Wahlstrom and Palte said costs generated through the dispute resolution process can ultimately contribute to health care spending and employer-sponsored coverage costs.
An audience question briefly shifted the discussion from financial to physical security. Asked whether UnitedHealthcare had changed operations following the fatal shooting of CEO Brian Thompson, in 2024, the speakers responded that the company had increased security.
Looking ahead, Wahlstrom and Palte said Georgia residents and employers should pay particular attention to specialty medications and emerging gene therapies. Those treatments can produce major medical breakthroughs, they said, while also becoming significant drivers of health care costs. The challenge ahead is making sure medical innovation does not outpace affordability.
