Latest / Becker’s Healthcare Podcast / Michael Charlton, MHL, President & CEO, AtlantiCare Health System

Transcript

Michael Charlton, MHL, President & CEO, AtlantiCare Health System · Becker’s Healthcare Podcast

• 0:02
  R one is the leader in health care
• 0:03
  revenue management, helping providers achieve new levels of
• 0:06
  performance through smart orchestration.
• 0:09
  With more than twenty years of experience, r
• 0:11
  one partners with 1,000 providers,
• 0:13
  including 95 of the top 100 US health
• 0:16
  systems and handles over 270,000,000
• 0:19
  payer transactions annually. If you want to learn
• 0:21
  more about how you can transform your revenue
• 0:23
  cycle operations, visit us at wwwr1rcm.com.
• 0:32
  Hello, and welcome to the Becker's Healthcare podcast.
• 0:34
  My name is Will Riley from r one.
• 0:37
  I'm joined today by Michael Charlton. Michael is
• 0:40
  president and CEO at AtlantiCare Health System in
• 0:44
  New Jersey.
• 0:45
  Welcome, Michael, to the podcast. Thank you, Will.
• 0:47
  It's a pleasure to be here with you
• 0:48
  today. Thank you.
• 0:49
  Michael, let's start. Tell us a bit about
• 0:51
  yourself.
• 0:52
  Tell us about AtlantiCare,
• 0:55
  the communities that you that you serve. Set
• 0:57
  the scene.
• 0:58
  Sure. So,
• 1:00
  as you said, I'm Michael Charlton. I am
• 1:02
  president and CEO of AtlantiCare Health System. I've
• 1:05
  been in this role for just over two
• 1:07
  years. Prior to that, I was the interim
• 1:09
  for about six months. And then prior to
• 1:12
  that,
• 1:13
  I was the board chair for seven years
• 1:14
  and a board member for about fifteen years.
• 1:17
  Atlanticare is quite a unique organization. It is
• 1:20
  the largest health care system in Southeastern New
• 1:23
  Jersey. We serve about a million people, have
• 1:25
  about 7,000
• 1:27
  caregivers in total with about a 120 sites
• 1:30
  of care.
• 1:32
  And,
• 1:33
  we are a 2,009 Baldrige winner, which at
• 1:36
  the time, we were one of only 17
• 1:38
  health systems in the world that had won
• 1:40
  that award. So incredibly proud organization. It's a
• 1:43
  125
• 1:44
  years old, has a long line of legacy,
• 1:47
  and serves our community well as the anchor
• 1:48
  institution.
• 1:50
  Thank you. Tell tell tell me a little
• 1:52
  bit more about that community. Is it urban,
• 1:54
  rural, suburban? Like, what what does it look
• 1:56
  like? Absolutely. So it's a little bit of
• 1:59
  a tale of two cities.
• 2:00
  One of our campuses is located in Atlantic
• 2:02
  City proper.
• 2:04
  As most people know, Atlantic City is a
• 2:06
  a gaming industry.
• 2:07
  It is a municipality
• 2:09
  of about 48 blocks and 38,000
• 2:11
  residents.
• 2:12
  It is highly urban. It is majority black
• 2:15
  and brown and underserved.
• 2:17
  It has areas of wealth and has areas
• 2:19
  of impoverishment.
• 2:21
  Our second campus is located more of, I
• 2:23
  wouldn't say, a rural area,
• 2:26
  but it's a more wooded
• 2:29
  area, more suburban area. And then our 110
• 2:31
  sites of care spread over multiple counties.
• 2:35
  So we have a mix of population and
• 2:37
  a mix of challenges that we deal with.
• 2:38
  Got it. Thank you.
• 2:40
  Tell me about some of the, initiatives that
• 2:43
  are top of mind for you, Michael, going
• 2:45
  into 2026.
• 2:47
  So about a year ago, we launched with,
• 2:50
  was Vision 2030, and it was a long
• 2:52
  range strategic plan and vision for the organization.
• 2:54
  And typically, health care systems,
• 2:57
  have two or three two or three year
• 2:59
  strategic plans. We thought it would be more
• 3:01
  prudent given the pace of change,
• 3:04
  and the time that it takes to really
• 3:05
  get hold on some of these initiatives
• 3:08
  to identify what is really gonna be worthy
• 3:11
  of doing in the next five or six
• 3:12
  years. So some of the key things that
• 3:14
  we did,
• 3:15
  particularly,
• 3:16
  which is in top of mind of everybody
• 3:18
  now, is around our innovation with Oracle Health.
• 3:21
  We were the first in the world to
• 3:23
  sign on with Oracle Health and their AI
• 3:25
  products.
• 3:26
  We're one of the first to beta test
• 3:27
  some of that products. And, really, it's it's
• 3:30
  what we call real time,
• 3:33
  one AtlantiCare system. So it's,
• 3:36
  AtlantiCare powered by Oracle, and Oracle will maintain
• 3:39
  the infrastructure from an IT perspective of majority
• 3:42
  of all of AtlantiCare systems.
• 3:44
  And, you know, that was kinda contrary to
• 3:46
  where the world is moving. You know?
• 3:49
  We see we see the world a little
• 3:51
  different, Will. We see the EHR as a
• 3:54
  box that you put information in. Super But,
• 3:56
  really, we feel the future is wrapped around
• 3:58
  how do you extrapolate that data into precision
• 4:00
  medicine and deliver precision care to the individuals
• 4:03
  that we serve.
• 4:05
  Also, we wanted to solve the challenge of
• 4:06
  clinical burnout.
• 4:08
  And, you know, when I went to my
• 4:10
  board back in 2000,
• 4:12
  '24, the question was, well, the world's moving
• 4:15
  to Epic, isn't it? But my thought process
• 4:17
  was this. When you looked at the key
• 4:19
  data
• 4:20
  and you looked at clinical burnout, if a
• 4:21
  majority of the systems were moving to Epic,
• 4:23
  why is caregiver satisfaction with EHR not getting
• 4:26
  any better? It's actually getting worse. Right?
• 4:29
  So these were some of the conversations we
• 4:31
  had with our board. We had deep long
• 4:33
  conversations
• 4:34
  with Oracle, Larry Ellison, Mike Cecilia, Seema Verma,
• 4:38
  and really decided that this was the path
• 4:39
  heading forward. So that is a key initiative
• 4:41
  that will be intertwined in everything that we
• 4:44
  do.
• 4:45
  We have service line expansion in oncology, cardiology,
• 4:47
  and neuroscience, obviously, because there's a great need
• 4:50
  within the community.
• 4:52
  Our serving community pillar is critical,
• 4:55
  because we know that, you know, 80% of
• 4:57
  what goes on in a person's health status
• 4:59
  is really outside the four walls of the
• 5:00
  health system.
• 5:02
  So at the end of the day, you
• 5:03
  know, what we've always talked about is
• 5:07
  it's either we have to affiliate, convene it,
• 5:09
  or partner. But if we don't do one
• 5:11
  of those three things, we're gonna end up
• 5:13
  owning it with inside the four walls. So
• 5:15
  how do we expand our presence as an
• 5:17
  anchor institution outside those four walls, whether it's
• 5:20
  food insecurity, housing insecurity,
• 5:22
  and some of those initiatives? So they're really,
• 5:26
  three of the key,
• 5:27
  parameters that we're moving the organization forward over
• 5:30
  the next four or five years with the
• 5:31
  idea by Vision 2030,
• 5:33
  we will have a substantial difference in the
• 5:35
  health outcomes of our population. Excellent. Okay. Thank
• 5:38
  you. I'd like to talk a little bit
• 5:40
  about technology
• 5:41
  to start with.
• 5:43
  Let me ask you
• 5:45
  one question. And it was interesting to hear
• 5:47
  you talk about your thoughts around the EHR
• 5:49
  because
• 5:50
  it feels that tech, health care traditionally, health
• 5:53
  care providers have been rather conservative
• 5:55
  when it comes to adopting technology,
• 5:58
  and have been cautious in their approach. But
• 6:00
  it also feels like that might be shifting
• 6:03
  a little bit with the advent of AI
• 6:05
  tools and technologies
• 6:07
  and this sense perhaps that large health systems
• 6:10
  are sitting on a massive and differentiating resource
• 6:13
  in all of their data.
• 6:15
  It sounds like that is part of your
• 6:18
  thought process around this. It is. I think
• 6:21
  any conversation I start around technology, I start
• 6:24
  with the root cause of the problem.
• 6:26
  And in this country, when we enacted meaningful
• 6:29
  use and the government spent $30.40, $50,000,000,000,
• 6:31
  what was the key thing that they left
• 6:33
  out? Interoperability.
• 6:35
  So the fact that these systems, fifteen, twenty
• 6:38
  years out, after meaningful use was initiated,
• 6:41
  do not talk to each other is the
• 6:43
  fatal flaw that starts everything.
• 6:45
  And then you build from there, you know,
• 6:47
  all the challenges. You know, having come from
• 6:49
  another industry, you know, I was the CEO
• 6:51
  of a hospitality company before.
• 6:53
  We build differently when it comes to technology.
• 6:55
  We build with the end user and what
• 6:57
  does that look like, and then we work
• 6:59
  backwards.
• 7:00
  With health care, it's always been, you know,
• 7:02
  we build a solution and then we try
• 7:03
  to implement it into what we're doing day
• 7:05
  to day from a task perspective. So I
• 7:08
  think from our perspective,
• 7:09
  we're looking at
• 7:10
  what does the end user, obviously, being the
• 7:13
  patient need from a consumer experience?
• 7:16
  What does the caregiver need to deliver better
• 7:18
  care and reduce burnout?
• 7:20
  And how do we create
• 7:22
  efficiency through the systems? Because cost is such
• 7:24
  a big challenge.
• 7:25
  That's how we're viewing all of this.
• 7:29
  You know, we're way past the days of
• 7:31
  where we're looking at is the EHR
• 7:33
  is anything more than, you know, a box
• 7:35
  to to put data in. But how do
• 7:37
  we extract the data?
• 7:38
  Yeah. And there's so many challenges, Will.
• 7:41
  There's systemic racism
• 7:43
  in how this data has been presented over
• 7:45
  the years. So you gotta be real careful
• 7:46
  when you're talking about AI
• 7:48
  and what's being generated out of AI. Is
• 7:50
  the data clean? Is it responsible?
• 7:52
  Right? Is it real? Is it effectuating change?
• 7:55
  So these are a lot of the things
• 7:57
  that we're looking at. We have great partners
• 7:59
  in Oracle and Oracle Health that are really
• 8:00
  helping us dive through all those things. So
• 8:03
  we're excited about what the future holds. As
• 8:05
  you look at that partnership,
• 8:06
  what are the advantages that you bring as
• 8:09
  a large incumbent
• 8:11
  in your
• 8:12
  community,
• 8:13
  and what are the advantages that Oracle brings
• 8:16
  or other technology providers bring that complement that?
• 8:20
  So we'll start with the theme that us
• 8:22
  in Oracle use all the time.
• 8:24
  We're big enough that it matters,
• 8:26
  and we're small enough that we can be
• 8:28
  nimble to an institute the change that needs
• 8:30
  to be instituted.
• 8:31
  What we bring to it
• 8:33
  is providing Oracle
• 8:35
  the opportunity to understand our workflows,
• 8:38
  what our caregivers are challenged with, what our
• 8:41
  patients are challenged with, what we see great
• 8:43
  experience looking like. What Oracle brings to us
• 8:46
  is, you know, a multibillion dollar multinational corporation
• 8:51
  that is across many domains,
• 8:53
  that has consumer experience across many domains and
• 8:55
  can bring that operating theory back into health
• 8:58
  care. Right?
• 9:00
  You know, it's always enamored me. People talk
• 9:02
  about health care in a sense whether it's
• 9:03
  cost or consumer experience. They'll they'll put us
• 9:06
  up against Starbucks or Walmart or Amazon. Right?
• 9:09
  But then we go back to strictly
• 9:11
  providers who are focused on health care. Oracle
• 9:14
  provides us that broader base. They also give
• 9:17
  us a seat at the table. So we
• 9:19
  get to co develop some of these and
• 9:20
  co create some of these solutions collectively and
• 9:22
  collaboratively together.
• 9:25
  But what we find is their size, their
• 9:27
  scale,
• 9:28
  their breadth and depth really gives us the
• 9:30
  ability to create change swiftly.
• 9:33
  And you're seeing that with a lot of
• 9:34
  our patients, whether it's our portal in the
• 9:37
  Edgienic AI that's built in the portal,
• 9:39
  whether it's with our caregivers that, the ambient
• 9:42
  listening technology,
• 9:44
  that's built into the EHR now, giving time
• 9:46
  back to the caregiver.
• 9:48
  A lot of those initiatives have been kicked
• 9:50
  off in the past year, but they're gaining
• 9:51
  momentum now.
• 9:53
  So you're describing a a sort of design
• 9:55
  philosophy or an innovation philosophy that's essentially outside
• 9:59
  in rather than inside out. Exactly. Yeah. Exactly.
• 10:02
  And,
• 10:03
  when you think about that then from, from
• 10:05
  the c suite of a health system,
• 10:07
  what does that mean in terms of how
• 10:09
  you govern those initiatives and how you prioritize
• 10:12
  projects and how you think about returns and
• 10:14
  and outcomes?
• 10:16
  So that's a great question.
• 10:18
  So, you know, one of the most controversial
• 10:20
  things that I've done in the CEO spot
• 10:22
  role in the past two years is when
• 10:24
  we set out on this initiative, this was
• 10:25
  a $100,000,000 investment that was over twenty seven
• 10:28
  months from beginning to implementation.
• 10:31
  Incredibly quick timelines. And what we said to
• 10:33
  the team was, we're not gonna take five
• 10:35
  years to do this. Nobody has the resilience
• 10:37
  to last five years on a project and
• 10:39
  to do their day to day work. Right.
• 10:42
  So we have to do it quickly. We
• 10:43
  have to be proficient.
• 10:45
  So how do we govern something like that?
• 10:47
  And one of the controversial things we said
• 10:49
  was we're not gonna do it solely on
• 10:50
  our side of the equation, meaning that we
• 10:53
  have a governance structure that I sit on
• 10:54
  the top, but also
• 10:56
  the president of Oracle Health sits there right
• 10:58
  with me. Got it. And then as the
• 11:00
  teams cascade down, there is a combination of
• 11:03
  Oracle executives and team members along with the
• 11:06
  AtlantiCare team members and executives. So we're intertwined.
• 11:09
  Not only are they intertwined at the governance
• 11:11
  level, but we also have 85 full time
• 11:13
  work lefties that are on-site for the next
• 11:15
  twenty seven months. And it's really about that
• 11:18
  integration. Right? How do we bet each other
• 11:21
  driving towards the same mission? Right? How does
• 11:23
  our cultures align, our vision mission align? And
• 11:25
  you gotta walk the talk. It's hard to
• 11:27
  do when you're on Teams meetings or one
• 11:29
  side owns the governance structure
• 11:31
  where you don't have the other side embedded
• 11:32
  in the day to day work. So,
• 11:34
  it's proven out at first. You know, it's
• 11:36
  it's scary because you're turning over some control.
• 11:40
  You know? We don't call them vendors. They're
• 11:41
  they're our partner in this. You're turning control
• 11:43
  over to your your partner in some senses,
• 11:45
  in some occasions,
• 11:47
  but it's built trust across the organization pretty
• 11:50
  quickly.
• 11:51
  You mentioned,
• 11:52
  issues with data and being
• 11:55
  cautious about interpreting results from data.
• 11:58
  How are you thinking about ethics and the
• 12:01
  responsible
• 12:03
  application of that data in this new sort
• 12:05
  of paradigm?
• 12:06
  So the easy answer is we're not gonna
• 12:09
  be first in on any of this.
• 12:11
  We're we're letting you know, we see a
• 12:12
  lot of things out there, whether it's radiological
• 12:15
  reads by AI,
• 12:16
  whether it's other applications of AI, even when
• 12:19
  it comes down to do an executive summary
• 12:21
  of clinical notes, you know, or your or
• 12:23
  your charting,
• 12:25
  you know, we're we're very cautious on making
• 12:28
  sure that this is proven technology, it's proven
• 12:31
  out,
• 12:32
  and then we don't have any blips in
• 12:34
  the screen. But I think the naive answer
• 12:35
  is we're just not gonna be first because
• 12:37
  a lot of this technology, as you know,
• 12:39
  is ubiquitous. Yeah. You know, it's a mile
• 12:42
  wide and an inch deep. So until there's
• 12:44
  little more depth and breadth to it, we're
• 12:46
  being real cautious. Got it. Okay. You touched
• 12:49
  briefly on a clinical use case and been
• 12:51
  listening. What are some of the other use
• 12:52
  cases that you're interested in
• 12:55
  that you think have real promise? And
• 12:57
  maybe can you describe any on the administrative
• 12:59
  side of health care? So I think, obviously,
• 13:02
  the big one we all know is rev
• 13:03
  cycle. You know, we know with pre auth
• 13:05
  denials,
• 13:07
  you know, the insurance companies are getting real
• 13:09
  prescriptive on how you know, I said this
• 13:11
  all the time jokingly. I don't think we
• 13:13
  have a revenue problem in health care. I
• 13:14
  think we have a denial problem.
• 13:16
  I think it's crossed the line where it's
• 13:18
  almost evil now. So
• 13:21
  the ability and the size and scale of
• 13:23
  these companies to invest in technology on the
• 13:25
  payer side has to be matched with the
• 13:28
  size and scale on the on the provider
• 13:29
  side. So rev cycle is a big opportunity
• 13:32
  for us. You know, with Oracle Health, one
• 13:34
  of the key initiatives here is how much
• 13:36
  Ingenik AI can they build into the rep
• 13:38
  cycle system so human contact
• 13:40
  is not the the key main driver of
• 13:42
  this. Right? That the Ingenik AI is learning
• 13:44
  and leading some of this because we know
• 13:46
  on the payer side, that's what they're doing.
• 13:48
  I think that's our main focus right now.
• 13:50
  Yeah. We need to make sure that
• 13:52
  the contractual obligation to pay us is there
• 13:55
  and that we have the technology to fight
• 13:57
  the pre auth, the denials, etcetera. I think
• 13:59
  from administrative standpoint, also, like we talked about,
• 14:02
  whether it's clinical documentation, whether it's charting, whether
• 14:05
  it's providing executive summary for tomorrow's appointments,
• 14:08
  from administrative burden, whether it's the ability to
• 14:11
  provide executive summary to long emails
• 14:14
  or reports.
• 14:15
  You know, all this is just a time
• 14:17
  saver. Right? And at the end of the
• 14:19
  day, what are we all striving for? We're
• 14:20
  striving for
• 14:22
  more time that is less valued to provide
• 14:25
  better time and more time to our patients.
• 14:27
  So I we see a lot of opportunity
• 14:29
  there. If we can get an hour, two
• 14:31
  hours a day, that compels.
• 14:33
  And so you there are workforce implications
• 14:36
  here. Right? Change to work, different work, work
• 14:38
  that was done by people that maybe now
• 14:40
  is done by a machine.
• 14:42
  The human plays a different role.
• 14:44
  How are you thinking about the change management
• 14:46
  associated with all of that with with your
• 14:48
  workforce? So that's a great question. I think
• 14:50
  the advantage health care has is we are
• 14:52
  chronically understaffed. Right? Right. We're chronically understaffed.
• 14:56
  So, you know, we've made huge investments into
• 14:59
  u university, which is our own university, and
• 15:01
  then our our, upcoming construction of our medical
• 15:04
  school to make sure that we can provide
• 15:07
  the education to support the workforce of the
• 15:09
  future and reposition some of our team members
• 15:12
  into other jobs that interest them and make
• 15:14
  sure that they have the substance and education
• 15:16
  to do that.
• 15:18
  We're in a fortunate situation
• 15:19
  that, you know, as AI
• 15:21
  evolves, our workforce will evolve,
• 15:24
  and we don't have to talk about people
• 15:26
  being laid off. You know, I think it's
• 15:28
  it's a little disingenuous
• 15:29
  to tell
• 15:31
  AI as a as a changer,
• 15:35
  you know, for for humanity.
• 15:37
  When you have companies,
• 15:39
  like
• 15:40
  Salesforce and Amazon that are implementing these technologies
• 15:43
  and then laying off 20,000 people or Salesforce
• 15:45
  laying off 4,000 people, these are multi, multibillion
• 15:49
  dollar organizations
• 15:50
  that have a broader responsibility
• 15:53
  to their workforce who built these organizations. And
• 15:55
  we take that,
• 15:56
  we take that personal. So we're looking forward
• 15:59
  to the AI revolution, but we're very cautious
• 16:01
  on how that will affect our workforce.
• 16:04
  Thank you very much, Michael. It's been really
• 16:06
  interesting talking to you. Are there any any
• 16:08
  thoughts that you want to leave us with?
• 16:12
  Yeah. I would just say it's a it's
• 16:13
  a very interesting time in health care. You
• 16:16
  know, we spoke about AI,
• 16:19
  and the challenges that possesses.
• 16:21
  But also right now from from the political
• 16:23
  standpoint standpoint of what's going on, it's it's
• 16:25
  incredibly challenging.
• 16:27
  So incredibly humbled to be a part of
• 16:30
  of health care,
• 16:32
  and just admire the people who are doing
• 16:34
  the work because it's incredibly difficult time.
• 16:38
  Thank you, Michael, for spending time with us
• 16:40
  today. We really appreciate it. Thanks. Appreciate it.