← Becker’s Healthcare Podcast
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- [00:02]
R1 Representative
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.
- [00:31]
Will Riley
Hello and welcome to the Becker Healthcare Podcast. My name is Will Riley from R1. I'm joined on the podcast today by Saad Etisham. Saad is president and CEO of Atlantic Health in New Jersey. Welcome to the podcast, Saad.
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Saad Etisham
Thank you, Will.
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Will Riley
It's great to have you and great to be talking to you. Can you start off please by telling us a little bit about yourself, your role and and tell us about Atlantic Health.
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Saad Etisham
Sure. So I've been with Atlantic Health for 100 days as their new president and CEO. So fairly new to the organization. Prior to that I was with Novant Health. I was the president of acute care operations for Novant, overseeing 19 hospitals, 10 billion in net revenue. Atlantic Health, let's talk about Atlantic, where I am. It's five and a half billion net revenue organization. It's got six hospitals, almost 1800 beds, tertiary facilities, very much anchored in the community. Morristown Medical center has been around since 1911. It is ranked among one of the top three hospitals in state of New Jersey by U.S. news & Report ranking Newsweek number one, Overlook Medical Centers. Number two, the community is just fantastic. That area is fantastic. We have about seven and a half million population that we serve around 14 counties, one in Pennsylvania as well in northern New Jersey, a state that has 9 million residents. So we're serving quite a large population there, very diversified. We're not academic medical center yet we have 550 medical students, we have 356 residents in the system and we have about $70 million worth of research happening at Atlantic Health as.
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Will Riley
Well. Wow. Okay, what are some of the key initiatives and priorities that you have on your agenda for Atlantic health going into.
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Saad Etisham
2026? The timing perfect for this podcast because we just pivoted and rolled out a three year strategic plan for our organization and I call it a journey. It's a journey to becoming a top performing national leader in healthcare and under which we have five priorities, strategic imperatives that we are focusing on. Number one is execute on clinical excellence and we can talk more about that. So number one, execute on clinical excellence. Number two, create brand loyalty and consumer stickiness. Number three is focused on our team, ensuring that we have a great experience for our team members. We're creating upskilling opportunities for our employees and also looking at ways to grow them within the organization. So a lot of focus on team members. Number four is sustainable growth. And the word sustainable is very purposeful there. And lastly on that is financial.
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Will Riley
Stewardship. Future proofing the organization, the focus on stewardship sustainability there. Can you tell unpack that a little bit.
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Saad Etisham
More. So the financial stewardship, we've set out that we want to attain a certain profit margin by 2026. We believe that's the margin that's going to be needed to be able to drive excess revenue to invest back into capital and strategic initiatives. And along with that is growing in our market share. Market share, synergistic market share in primary and secondary service areas. Looking at growth opportunities and partnership, very important. It's probably not going to be possible for health systems to continue to own everything. I think we need to look at partners out there that we can leverage and have growth. Joint venture opportunities exist as well. So part of that is that sustainable growth that we can continue to build upon and expand from where we are in our region into surrounding regions as.
- [04:48]
Will Riley
Well. Okay, fantastic. Thank you. I'd like to start by talking about technology and the adoption of technology at large health systems like yours. It feels like historically large health systems have been quite conservative when it comes to the adoption of technology. But it also feels like potentially that's changing with the advent of AI solutions to help both on the clinical side and the administrative side of healthcare. And there's this real sense of enthusiasm and energy around using those that maybe is different from different eras of technology we've seen in healthcare in the past. Do you agree with that? Is that how you see it playing out too? Or is it.
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Saad Etisham
Different? No, I agree. There's a lot of excitement about technology. How can we leverage technology to advance clinical outcomes? How can we use technology from administrative documentation burden make it easier for our clinicians and our teams to provide care? So that excitement is there. And I've always been a fan. I would call myself a cautious techno enthusiast. I do like technology, but I have a unique spin on that. For me, most people are looking at technology as the next wave of how we're going to get better without really understanding what you're trying to get better at. And for me, in my teams, what I tell them, what is the problem you're trying to solve? Identify the problem, know what you're trying to solve, and when you solve it, what does it get you and it needs to be grounded in. It has impact on patient outcomes, it has an impact on team member experience, it has an impact on patient experience and at the end of the day it has a return on investment or a value on investment and that that could be soft quantifiable things. Once you know all those things then go find the solution. On the AI side what I'm seeing is people are looking for solutions, they find the solution, they get excited about that technology, then they go looking for problems to solve for within the health system. It's.
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Will Riley
Backwards.
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Saad Etisham
Yeah. So I'm flipping it a little.
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Will Riley
Bit and that, I mean that leads you me straight to governance and how you then govern the deployment of this technology and where you make your bets. Basically yes. Can you talk a little bit about any governance structures or systems that.
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Saad Etisham
You'Re setting up so on there we just stood up recently comprised of clinical leaders, administrative executive team members and others. What we call is a joint venture slash product development evaluation committee in that where we evaluate all the different technologies that are coming through along with all the other joint ventures. But we're focused on the technology piece and we also have what we call a venture studios arm which is almost. We have 60 million dedicated to private equity funding to startups in technology, health care, healthcare, adjacent companies. So that all funnels through there and the governance is to really look at the principles of what we're trying to do. As I mentioned before, what is the problem we're trying to solve? How does that impact. And we put the patient lens, we put the team member lens, we put the financial lens through it and you got to have that. And once you know that this is the product that makes sense then you got to involve a broader stakeholder group, the end users. You really got to bring them to the table upfront early on because the fear usually is is AI going to replace me? I don't believe AI is going to replace people because the cognitive abilities and that the clinicians have is never going to be replaced. But it's going to augment their decision making much faster. So we, I like to involve the clinicians in that decision making process, vet process I think is very important. Once you do that you're really going to understand how does that alter our workflows. That's where people usually fail. They're trying to put a square peg in a round hole and it doesn't work. So you got to understand your workflows because it may alter the way care is delivered and that's why you need those Clinicians to be able to say, yeah, this has value and we're willing to change the way we deliver care and our pathways. And if you can get alignment on all those areas, you're going to be very much successful. So the governance structure has to be in place to look at it. Why, how, where and what's it going to.
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Will Riley
Accomplish. Okay, very interesting. You mentioned as well some venture partnerships. And I'm curious to ask more about that because it feels like in healthcare there are two sort of archetypes of innovation. Your incumbent, large health system, large payer, large technology provider established with the data, with the infrastructure, and then an alternative model of more of an insurgent model disruptor, maybe in our world, AI, native data first, but without some of the benefits of incumbency. It sounds like you're trying to build an innovation agenda and approach that somehow juggles those two archetypes. Is that.
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Saad Etisham
Right? We're trying to be in the middle.
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Will Riley
Somewhere.
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Saad Etisham
Right. What I'm telling my teams is we need to think about is disrupting.
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Will Riley
Ourselves. I.
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Saad Etisham
See. If we can disrupt ourselves and innovate around that and know why we're innovating, we're going to be successful. Because then you're not reacting to what's coming down the pike. You know, we talk about all the regulatory changes and policies coming and people react to them. What I like to do is build a system that knows its identity, knows where it's going and knows how to get there and not worry about what's coming down the pike. I mean, sure, you got to worry about it, but if you're always in reactive mode, you're in survival.
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Will Riley
Mode.
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Saad Etisham
Yeah. And I'd rather us not be in a reactive.
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Will Riley
Mode. And you bring some significant advantages as a large incumbent, I would think. And you want to play to those advantages and to those.
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Saad Etisham
Strengths. Absolutely. I want to invite our teams, use the principles of higher reliability, organization, deference to expertise, engagement at all levels from the clinical teams, from our physician providers, and from the administrative side, the corporate overhead enterprise side, to say, look, this is what we're trying to do. This is how we're going to accomplish it. So you have shared data governance along with clinical expertise, married together with a common objective of advancing care. At the end of the day, it's really about patient outcomes and patient experience. And if you keep that grounded as the Central North Star, you're going to do.
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Will Riley
Well. Can we talk a little bit about the administrative side now and how it can benefit from the application of some of these new technologies? Perhaps you could start by telling us about your payer mix and some of the payer relations that you.
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Saad Etisham
Have. Sure. So we happen to be in a pair mix of like Most systems, we're 50% governmental, Medicare, Medicare Advantage and Medicaid with portions of self pay as well. And the rest of it is different levels of managed care contracting. Ironically, Atlantic Health is in my opinion much more advanced than most health Systems. We have 38% of our revenue is through risk based contracts. So we're already at 38%. We have two large ACOs that are managing population health with upwards of a couple of thousand providers in each of the ACOs has done really well. Our POP health strategy is pretty robust. I've challenged the team in the next three years to try to get from 38 to 43, 45% of total book of business at Value Based Care. You have to be cautious there because we don't know how the policies coming from the administration are going to pivot and change. So a little bit cautious, but we will need to grow that. So Paramex gives us an opportunity to look at it from the governmental side and also from a commercial.
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Will Riley
Side. And so in terms of the application of new technologies like AI for example, on the administrative side, that process historically has been an area that has been very labor intensive for health systems. Lots and lots of people. Technology's been used in places like revenue cycle, but it's always seems to have been more of an assistant and secondary. Right. But with new technologies like AI, it feels like an area that's ripe to pivot essentially and become technology first, labor.
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Saad Etisham
Second. Very much so. So you know, let's take, talk about coding. Right. Techno, there's, there's technology out there from artificial intelligence that can mine the, the electronic medical records and, and code the medical record ready for building. That's where the human portion comes in to just look at the speed and velocity of all those coding things that are happening. And one human still need to look at it, make sure it meets the reasonableness. So you leverage the ability of one coder to be able to do multiple things at the same time without having multiple coders doing singular. So your parallel processing, I think that's the huge advantage there as well. Denials is another area where we can do that, use AI to advance, reduce our administrative burden as well, which is people dependent process. So it's almost leveraging people to be more.
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Will Riley
Efficient. Yes, yes, yes. Rather in the way you've described the clinical side. Yes, yeah, exactly. Yeah, yeah, yeah. Okay. And maybe to, to to wrap up. How do you see some of these technology advancements benefiting the patient ultimately? Because you've said that's the North Star.
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Saad Etisham
Yes. So to be better outcomes at a lower cost would is eventually going to lower the burden on our consumers from out of pocket. That's really the end game. At the end of the day, we got to give them a product that improves their health. We want to be partners in their journey. And if we could do it at our low cost value in the right setting. It doesn't need to be in the acute setting. It has to be in the right setting. Whether it's inpatient, outpatient or physician offices. We want to meet the patients where they want to be met. And so to me, that's the.
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Will Riley
Advantage. Yeah. Yeah. Okay. Saad, it's been great talking to you. Do you have any concluding thoughts or things that we haven't covered that you want to bring.
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Saad Etisham
Up? Just echo again, reinforce, know what the problem you're trying to solve before you go seek the AI solution and have a governance structure in place that involves clinicians at the bedside in implementing that or administrative style and take the fear away that technology is replacing them because it's not. It's aiding them to be more.
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Will Riley
Efficient. Wonderful. Thank you. Thanks so much. It's been really great talking to you. Thank you.
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Saad Etisham
Sir. Thank you. Will appreciate it.