← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Michael Charlton, MHL, President & CEO, AtlantiCare Health System
00:16:56
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- [00:02]
A
R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 US health systems and handles over 270 million payer transactions annually. If you want to learn more about how you can transform your revenue cycle operations, Visit us at www. R1RCM.
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B
Hello and welcome to the Beckers Healthcare podcast. My name is Will Riley from R1. I'm joined today by Michael Charlton. Michael is president and CEO at Atlantic Air Health System in New Jersey. Welcome, Michael, to the podcast.
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C
Thank you, Will. It's a pleasure to be here with you today.
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B
Thank you, Michael. Let's start. Tell us a bit about yourself. Tell us about atlanticare. The communities that you, that you serve, set the scene.
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C
Sure. So, as you said, I'm Michael Charlton. I AM President and CEO in AtlasCare Health System. I've been in this role for just over two years. Prior to that I was the interim for about six months and then prior to that I was the board chair for seven years and a board member for about 15 years. AtlantiCare is quite a unique organization. It is the largest healthcare system in southeastern New Jersey. We serve about a million people, have about 7,000 caregivers in total with about 120 sites of care. And we are a 2009 Baldrige winner, which at the time we were one of only 17 health systems in the world that had won that award. So incredibly proud organization. It's 125 years old, has a long line of legacy and serves our community well as the anchor institution.
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B
Thank you. Tell me a little bit more about that community. Is it urban, rural, suburban? Like what does it look like?
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C
Absolutely. So it's a little bit of a tale of two cities. One of our campuses is located in Atlantic City proper. As most people know, Atlantic City is a gaming industry. It is a municipality of about 48 blocks and 38,000 residents. It is highly urban. It is majority black and brown and underserved. It has areas of wealth and has areas of impoverishment. Our second campus is located in more of, I wouldn't say a rural area, but it's a more wooded area, more suburban area. And then our 110 sites of care are spread over multiple counties. So we have a mix of population and a mix of challenges that we deal with.
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B
Got it. Thank you. Tell me about some of the initiatives that are top of mind for you, Michael. Going into 2026.
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C
So about a year ago we launched what was Vision 2030 and it was a long range strategic plan and vision for the organization. And typically healthcare systems have two or three year strategic plans. We thought it would be more prudent given the pace of change and the time that it takes to really get hold on some of these initiatives to identify what is really going to be worthy of doing in the next five or six years. So some of the key things that we did particularly, which is in top of mind of everybody now, is around our innovation with Oracle Health. We were the first in the world to sign on with Oracle Health and their AI products. We were one of the first to beta test some of that products and really it's what we call real time. One Atlanticare system. So it's Atlanticare powered by Oracle and Oracle will maintain the infrastructure from an IT perspective of majority of all of Atlanticare systems. And you know, that was kind of contrary to where the world is moving. You know, we see the world a little different will we see the EHR as a box that you put information in. But really we feel the future is wrapped around how do you extrapolate that data into precision medicine and deliver precision care to the individuals that we serve. Also we wanted to solve the challenge of clinical burnout. And you know, when I went to my board back in 2024, the question was, well, the world's moving to epic, isn't it? But my thought process was this. When you looked at the key data and you looked at clinical burnout, if a majority of the systems were moving to epic, why is caregiver satisfaction with EHR not getting any better? It's actually getting worse. Right. So these were some of the conversations we had with our board. We had deep, long conversations with Oracle, Larry Ellison, Mike Cecilia, Sima Verma and really decided that this was the path heading forward. So that is a key initiative that will be intertwined in everything that we do. We have service line expansion in oncology, cardiology and neuroscience obviously because there's a great need within the community. Our serving community pillar is critical because we know that, you know, 80% of what goes on in a person's health status is really outside the four walls of the health system. So at the end of the day, you know, what we've always talked about is it's either we have to affiliate, convene it or partner, but if we don't do one of those three things, we're going to end up owning it with Inside the four Walls. So how do we expand our presence as an anchor institution outside those four walls, whether it's food insecurity, housing insecurity, and some of those initiatives. So they're really three of the key parameters that we're moving the organization forward over the next four or five years with the idea by Vision 2030, we will have a substantial difference in the health outcomes of our population.
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B
Excellent. Okay, thank you. I'd like to talk a little bit about technology to start with. Let me ask you one question, and it was interesting to hear you talk about your thoughts around the ehr, because it feels that healthcare, traditionally healthcare providers have been rather conservative when it comes to adopting technology and have been cautious in their approach. But it also feels like that might be shifting a little bit with the advent of AI tools and technologies and this sense perhaps, that large health systems are sitting on a massive and differentiating resource in all of their data. It sounds like that is part of your thought process around this.
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C
It is. I think any conversation I start around technology, I start with the root cause of the problem. And in this country, when we enacted meaningful use and the government spent 30, 40, $50 billion, what was the key thing that they left out? Interoperability. So the fact that these systems 15, 20 years out after meaningful use was initiated do not talk to each other is the fatal flaw. That starts everything and then you build from there. You know, all the challenges, you know, having come from another industry, you know, I was the CEO of a hospitality company before. We build differently when it comes to technology. We build with the end user and what does that look like? And then we work backwards. With healthcare, it's always been know we build a solution and then we try to implement it into what we're doing day to day from a task perspective. So I think from our perspective, we're looking at what does the end user, obviously being the patient, need from a consumer experience, what does the caregiver need to deliver better care and reduce burnout? And how do we create efficiency through the systems because cost is such a big challenge. That's how we're viewing all of this. You know, we're way past the days of where we're looking at is the EHR is anything more than, you know, a box to. To put data in, but how do we extract the data? And there's so many challenges, Will. There's systemic racism in how this data has been presented over the years. So you got to be real careful when you're talking about AI and what's being generated out of AI. Is the data clean? Is it responsible? Right. Is it Real is it effectuating change? So these are a lot of the things that we're looking at. We have great partners in Oracle and Oracle Health that are helping us dive through all those things. So we're excited about what the future holds.
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B
As you look at that partnership, what are the advantages that you bring as a large incumbent in your community and what are the advantages that Oracle brings or other technology providers bring that complement that?
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C
So we'll start with the theme that us in Oracle use all the time. We're big enough that it matters and we're small enough that we can be nimble to an institute. The change that needs to be instituted, what we bring to it is providing Oracle the opportunity to understand our workflows, what our caregivers are challenged with, what our patients are challenged with, what we see great experience looking like. What Oracle brings to us is a multi billion dollar multinational corporation that is across many domains, that has consumer experience across many domains and can bring that operating theory back into health care. Right. You know, it's always enamored me. People talk about health care in a sense, whether it's cost or consumer experience. They'll, they'll put us up against Starbucks or Walmart or Amazon. Right. But then we go back to strictly providers who are focused on health care. Work provides us that broader base. They also give us a seat at the table. So we get to co develop some of these and co create some of these solutions collectively and collaboratively together. But what we find is their size, their scale, their breadth and depth really gives us the ability to create change swiftly. And you're seeing that with a lot of our patients, whether it's our portal and the agency AI that's built in the portal, whether it's with our caregivers that the ambient listening technology that's built into the EHR now, giving time back to the caregiver. A lot of those initiatives have been kicked off in the past year, but they're gaining momentum now.
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B
So you're describing a sort of design philosophy or an innovation philosophy that's essentially outside in rather than inside out.
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C
Exactly.
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B
Yeah, exactly. And when you think about that, then from a, from the C suite of a health system, what does that mean in terms of how you govern those initiatives and how you prioritize projects and how you think about returns and outcomes.
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C
So that's a great question. So, you know, one of the most controversial things that I've done in the CEO spot role in the past two years is when we set out on this initiative, this was a $100 million investment that was over 27 months from beginning to implementation, incredibly quick timelines. And what we said to the team was, we're not going to take five years to do this. Nobody has the resilience to last five years on a project and to do their day to day work. So we have to do it quickly, we have to be proficient. So how do we govern something like that? And one of the controversial things we said was we're not going to do it solely on our side of the equation. Meaning that we have a governance structure that I sit on the top, but also the president of Oracle Health sits there right with me. And then as the teams cascade down, there is a combination of Oracle executives and team members along with the Atlanticare team members and executives. So we're intertwined. Not only are they intertwined at the governance level, but we also have 85 full time Oracle FTS that are on site for the next 27 months. And it's really about that integration. Right. How do we bet each other driving towards the same mission? Right. How does our cultures align, our vision, mission aligned? And you got to walk the talk. It's hard to do when you're on teams meetings or one side owns the governance structure where you don't have the other side embedded in the day to day work. So it's proven out at first. You know, it's, it's scary because you're turning over some control. You know, we don't call them vendors, they're, they're our partner in this. You're turning control over to your, your partner in some senses, in some occasions. But it's built trust across the organization pretty quickly.
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B
You mentioned issues with data and being cautious about interpreting results from data. How are you thinking about ethics and the responsible application of that data in this new sort of paradigm?
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C
So the easy answer is we're not going to be first in on any of this. We're letting you know we see a lot of things out there, whether it's radiological reads by AI, whether it's other applications of AI, even when it comes down to do an executive summary of clinical notes, you know, you're, or you're charting, you know, we're very cautious on making sure that this is proven technology, it's proven out and then we don't have any blips in the screen. But I think the naive answer is we're just not going to be first because a lot of this technology, as you know, is ubiquitous. Yeah, you know, it's a mile wide. And an inch deep. So until there's a little more depth and breadth to it, we're being real cautious.
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B
Got it. Okay. You touched briefly on a clinical use case. Ambient listening. What are some of the other use cases that you are interested in that you think have real promise and maybe can you describe any on the administrative side of healthcare?
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C
So I think obviously the big one we all know is Rep Cycle. You know, we know with pre auth denials, you know, the insurance companies are getting real prescriptive on how, you know, I say this all the time jokingly. I don't think we have a revenue problem in healthcare. I think we have a denial problem. I think it's crossed the line where it's almost evil now. So the ability and the size and scale of these companies to invest in technology on the payer side has to be matched with the size and scale on the provider side. So Rep Cycle is a big opportunity for us. With Oracle Health, one of the key initiatives here is how much agenic AI can they build into the Rep cycle system. So human contact is not the key main driver of this, right? That the agency is learning and leading some of this because we know on the payer side that's what they're doing. I think that's our main focus right now. We need to make sure, sure that the contractual obligation to pay us is there and that we have the technology to fight the pre author denials, etc. I think from administrative standpoint also, like we talked about, whether it's clinical documentation, whether it's charting, whether it's providing executive summary for tomorrow's appointments from administrative burden, whether it's the ability to provide executive summary to long emails or reports, you know, all this is just a time saver, right? And at the end of the day, what are we all striving for? We're striving for more time that is less valued to provide better time and more time to our patients. So we see a lot of opportunity there. If we can get an hour, two hours a day that compounds.
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B
And so there are workforce implications here, right? Changed work, different work, work that was done by people that maybe now is done by a machine, that human plays a different role. How are you thinking about the change management associated with all of that with your workforce?
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C
So that's a great question. I think the advantage healthcare has is we are chronically understaffed, right? We're chronically understaffed. So you know, we've made huge investments into U University, which is our own university, and then our upcoming construction of our medical school to make sure that we can provide the education to support the workforce of the future and reposition some of our team members into other jobs that interest them and make sure that they have the substant education to do that. We're in a fortunate situation that, you know, as AI evolves, our workforce will evolve and we don't have to talk about people being laid off. You know, I think it's, it's a little disingenuous to tout AI as a, as a changer, you know, for, for humanity when you have companies like Salesforce and Amazon that are implementing these technologies and then laying off 20,000 people or Salesforce laying off 4,000 people. These are multi, multi billion dollar organizations that have a broader responsibility to their workforce who built these organizations and we take that personal. So we're looking forward to the AI revolution, but we're very cautious on how that will affect our workforce.
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B
Thank you very much. Michael, it's been really interesting talking to you. Are there any thoughts that you want to leave us with?
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C
Yeah, I would just say it's a very interesting time in healthcare. We spoke about AI and the challenges that possesses, but also right now, from the political standpoint of what's going on, it's incredibly challenging. So incredibly humbled to be a part of, of healthcare and just admire the people who are doing the work because it's incredibly difficult time.
- [16:38]
B
Thank you, Michael, for spending time with us today. We really appreciate it. Thanks. Appreciate it.