AtlantiCare CEO on how he evaluates AI’s return on investment

AI aims to help healthcare decisionmakers with everything from revenue cycle management to prior authorization to staffing to simply improving clinician satisfaction.

But, presented with seemingly unlimited applications, it can be tough for leaders to know which AI investments are worth the money, especially in the face of rising healthcare costs.

To understand how leaders are making these decisions, Healthcare Brew talked with Michael Charlton, president and CEO of the New Jersey-based AtlantiCare health system, at the Oracle Health and Life Sciences conference in Orlando, Florida, on Sept. 23.

This interview has been edited for length and clarity.

AtlantiCare, like many healthcare systems, has rolled out a number of AI tools. How do you think healthcare should define and measure AI’s return on investment (ROI)?

As healthcare organizations, our resources are usually strained, given the complexity of the system and what we’re trying to achieve. So on the business side, you have to make sure that there’s a return on capital, whether that is a reduction of full-time equivalent employees, whether it’s a productivity gain, or it is that we have an absorption of work as we go forward and we’re not going to have to hire tens of thousands of people moving forward because AI is going to do that.

I don’t like talking about ROI when it comes to a patient. We’re delivering care at probably somebody’s most vulnerable time. But the way I would define that is not monetarily; I would define it as: Is it creating additional access for the patient? Is it creating a smoother flow for a patient through the system? Am I getting, as a patient, a more declarative understanding of my condition and what I need to do to manage that condition?

What’s an example of ROI in your system?

The most prolific thing we’ve done as far as AI is the Oracle clinical AI agent.

[The agent] gave back 66 minutes a day to the physician. When you think about that, that is a physician who’s seeing patients from 7 a.m. to 3 p.m., and then has documentation time, and then most likely was going home for pajama time. So at the end of the day, 66 minutes meant physicians are getting home at 5 o’clock. They’re seeing the kids. They’re making dinner. They’re going to soccer games. That was incredibly impactful. The ROI was really significant.

You were one of the early adopters of that tool as part of a six-year partnership with Oracle. What’s an important lesson that you’ve learned?

The lesson learned is really how we govern that [adoption of tech] all the way through. Transformations of these scales are never easy.

You have a lot of stakeholders. You have physicians, you have nurses, you have administrators, you have back of the house team members. Everybody has their wants, wishes, needs, and desires. You need a group of people on both sides of the equation that are going to make sure that all that information coming in is funneled and finite, and we stay on track, and we stay directionally moving toward what we said we were going to do.

This summer, AtlantiCare also pledged to be an early adopter of federal 2027 electronic prior authorization requirements. Do you think there’s more that health systems and providers need to be doing in order to move this transition along, or is the ball really in the payers’ court?

I think it’s a combination. I think this is one where you are going to need Centers for Medicare and Medicaid Services and government intervention. We’re all talking in circles. Everybody just needs to get in the room and just figure it out.

I used to be the chairman of [a health plan]. We had a patient council, and I’ll never forget, we put the executives, from the president down, in the room, and one of the patient council members walked in with an explanation of benefits and said, “I don’t know what the hell this is. Explain this to me.” And we had a bunch of executives looking at it like, “God, I don’t know. I can’t figure it out.” And I only say that anecdotally because I think that’s where we are. I think we’ve all yelled and screamed for so long, we don’t even understand some of the things we’re talking about anymore. We try to polish it and make it look good. I don’t know the answer at this point.