Podcast Summary: Becker’s Healthcare Podcast

Episode: Garrick Stoldt, VP Finance and Chief Financial Officer at Saint Peter's Healthcare System
Date: January 20, 2026
Host: Will Riley
Guest: Garrick Stoldt, CFO, Saint Peter’s Healthcare System, New Jersey

Overview

This episode dives into how Saint Peter's Healthcare System—a standalone, safety net hospital in central New Jersey—remains competitive among much larger health systems, while facing challenging financial and regulatory climates. CFO Garrick Stoldt shares strategic insights on using technology (particularly AI), elevating clinical and patient satisfaction standards, and rethinking revenue cycle management to sustain operational excellence and navigate sweeping healthcare policy changes.

Key Discussion Points & Insights

1. Saint Peter’s Positioning & Community Impact

• Hospital Snapshot: Single-hospital, 478 beds, major teaching facility, strong women and children’s services, Magnet recognition for nursing, and Leapfrog A performance (00:59–01:37).
  • “We're a single hospital system… 478 beds… known for women and children services… also a safety net hospital. We have a high percentage, about 25% Medicaid.” – Garrick Stoldt, (01:13)
• Community Challenges: Serves New Brunswick, NJ, the fourth highest percentage of residents below the poverty guideline in the state; operates in a highly competitive market surrounded by multi-hospital giants (01:42–02:22).
  • “We're a standalone in a sea of giants in terms of financial size.” – Garrick Stoldt, (02:07)

2. Competitive Differentiators – Quality, Cost, Service

• Strategic Pillars: High patient satisfaction, excellent quality, lower cost (02:30–03:11).
  • “We have to have high patient satisfaction, very high quality at a much lower cost, and we compete well on all three of those.” – Garrick Stoldt, (02:30)
  • Noted as Magnet Hospital for nursing, consistently Leapfrog A rated, and in top 2 in state for patient “most likely to recommend.”
  • “Our financial performance… our balance sheet is now stronger than it's ever been in 117 years.” – Garrick Stoldt, (03:05)

3. Strategic Adoption of Technology and AI

• Pragmatic Approach: New technology—especially AI—must have a clear, justifiable ROI, particularly for significant investments (03:41–05:32).
  • “There are many things that AI can do for us, but is it really going to change the needle?... If it’s a large investment, it’s got to have an ROI.” – Garrick Stoldt, (03:45)
• Innovative Enrollment Support: Partnered with a company to use AI for streamlining Medicaid and charity care enrollment, shifting from a manual to a mobile app-based process, improving compliance with new laws (05:32–06:09).
  • “We have an app put on their phone and we teach them how to image the documents. Automatically goes into the platform, determines whether it goes into the Medicaid bucket or… charity care… completes the application, automatically sends it on to Medicaid.” – Garrick Stoldt, (05:44)

4. AI’s Multi-Dimensional ROI

• Clinical Applications: AI’s potential extends beyond admin/revenue cycle to predicting clinical deterioration—supporting quality and patient satisfaction (06:37–07:33).
  • “They were using it for presumptive elements of trying to predict a patient who [is] going to go south… able to intervene before a negative event.” – Garrick Stoldt, (06:54)
  • "Word of mouth still carries the day… you’re a high quality, low cost facility." – Garrick Stoldt, (07:23)

5. Revenue Cycle Overhaul & Denial Management

• Pandemic-Era Challenge: Payer denials soared from below 2% to 9–10% post-pandemic; required comprehensive review and retooling (08:08–09:13).
  • “It seemed like all the payers… figured how do we go ahead and screw hospitals out of money? And the denial rates absolutely shot through the roof.” – Garrick Stoldt, (08:28)
• Strategic Solutions:
  • Added utilization review nurses, beefed up physician advisors, leveraged specialized clinical expertise in denials, and invested in technology for trends/tracking (09:14–11:51).
  • Adopted a specialist–peer review model for appeals: neonatologists for NICU denials, geneticists for high-cost pediatric drugs.
  • “Our peer to peer turnover rate was about 35% now we just hit 80% in the last quarter.” – Garrick Stoldt, (11:48)
• Result: Denial rates now back down to about 2.5%, near pre-pandemic levels.

6. Patient Interface Technology & Future Automation

• Current Focus: Implementing EPIC EHR, which puts other automation plans temporarily on hold (12:56–13:31).
• Future Vision: Targeting 25–30% automation in revenue cycle functions over 5 years, via AI and robotics.
• People & Roles: Automation seen as a tool for redeployment, not layoffs (13:55–15:11).
  • “I don’t want to see people losing their jobs because of automation… there has to be monitored by people… sometimes the tool automation may be better than people and sometimes the people may be better than the tool.” – Garrick Stoldt, (14:19), (15:05)

7. The Impact of "The Big Beautiful Bill" & Ongoing Operational Excellence

• Legislative Impact: New law (the "big beautiful bill") significantly impacts Medicaid timelines and hospital margins; Saint Peter’s responded with a “performance excellence” initiative across 8 operational areas (15:17–17:00).
  • “The Hospital association in New Jersey… says that if you aggregate all the hospitals bottom lines over the next seven years, we’re going to lose 2/3 of that margin if nothing else changes.” – Garrick Stoldt, (16:22)
  • “If you’re not changing your operations now, then you’re going to be in a serious world of hurt.” – Garrick Stoldt, (17:01)

Notable Quotes & Memorable Moments

• On Standing Out in a Crowd:
  “We're a standalone in a sea of giants in terms of financial size.” – Garrick Stoldt, (02:07)

• Technology ROI Philosophy:
  “If it doesn’t change a needle from a performance standpoint, it’s kind of hard to justify… if it’s a large investment, it’s got to have an ROI to it.” – Garrick Stoldt, (03:45)

• AI for Enrollment:
  “We have an app put on their phone and we teach them how to image the documents. Automatically goes into the platform…” – Garrick Stoldt, (05:44)

• Payer Denials, Post-Pandemic:
  “It seemed like all the payers… figured how do we go ahead and screw hospitals out of money?” – Garrick Stoldt, (08:28)

• On Using Specialists for Denials:
  “It’s almost like a boxing match. We’ll have a neonatologist specialist go up against a primary care doctor... our peer to peer turnover rate was about 35% now we just hit 80% in the last quarter.” – Garrick Stoldt, (11:46–11:48)

• On AI & Workforce:
  “I don’t want to see people losing their jobs because of automation… I look at [AI] as a tool, as one of the many tools…” – Garrick Stoldt, (14:19–15:05)

• On Urgency for Change:
  “If you’re not changing your operations now, then you’re going to be in serious world of hurt.” – Garrick Stoldt, (17:01)

Key Timestamps

• 01:13 – Saint Peter’s hospital profile and population served
• 02:07 – Competing in a market dominated by large health systems
• 03:41 – Strategic approach to AI investments
• 05:44 – AI use in Medicaid/charity care enrollment
• 08:08 – Revenue cycle and the surge in payer denials
• 11:48 – Specialist involvement in payer appeals and results
• 13:55 – The future of automation, workforce strategy
• 16:22 – Forecast: impact of new legislation on hospital margins
• 17:01 – Final call for urgent operational transformation

This episode offers actionable insights into how a nimble hospital system leverages technology, specialized care, and relentless process improvement to safeguard financial health and patient care—even as policy and market forces rapidly evolve.