It has been about two and a half years since Atlantic City, N.J.-based AtlantiCare launched Vision 2030, a six-year strategic plan Michael Charlton unveiled in April 2024, about six months after he became president and CEO.
Now, Mr. Charlton said, the plan is moving past its early groundwork.
“The vision we set out is still holding firm, and our progress toward it is really starting to accelerate,” he said. “Early on we were building a lot of foundational elements around those four key pillars. But now we’re really starting to see progress.”
Vision 2030 is built on four pillars: serving community, workplace excellence, accelerating transformation and growing market share. Goals include expanding life expectancy in the region by five years, reducing food insecurity among patients by 6%, reducing unsheltered homelessness by 20% and growing AtlantiCare into a $2 billion organization. The plan launched alongside partnerships with Cleveland Clinic Cancer Institute, Global Neurosciences Institute and Oracle Health. In April, AtlantiCare and Temple University’s Lewis Katz School of Medicine in Philadelphia formalized an agreement to open a medical school campus in Atlantic City, with the first students expected in August 2029.
Mr. Charlton recently spoke with Becker’s about his priorities heading into 2027, a new cost-reduction program called Thrive, how AtlantiCare decides when to partner and why he believes health system leaders need to “take the big swings.”
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What are your top priorities heading into 2027, and what has changed in how you’re thinking about them over the past year?
Michael Charlton: My key tenet in leading Vision 2030 is that we base it on the five or six things we know are not going to change. That’s our North Star, so we always stay focused on those. But the biggest thing you have to adapt to is the changing healthcare funding environment, particularly the focus on reducing costs and Medicaid spending.
In New Jersey, we have NJ FamilyCare. Reimbursement is getting quite difficult. I wouldn’t say it’s redefining our work, but it is changing how we look at running the system to make sure we’re delivering world-class clinical care and quality. We also have to start reducing our cost structure and prioritizing what needs to get done.
Then we have to have those conversations with state and federal legislators. We’re being asked to do more when it comes to social determinants of health and care outside the four walls of the hospital. We need to understand how that’s possible and agree on a path forward.
That’s what’s changed. With AI, insurance companies, prior authorization denials and our ability to adjudicate claims, everything is coming at us much faster than before.
Q: Vision 2030 includes specific targets, like adding five years to life expectancy. How do you set measurable goals like that, and how do you hold the organization accountable to them?
MC: Accountability is really the core strength of Vision 2030. You set out a long-term vision, then bring stakeholders together, both internal and external, and align them with that vision. I’m not saying we won’t adjust some things over six years, because good leadership means continuously learning and adapting.
The goals you mentioned, particularly under our pillar of serving the community, are incredibly important. Atlantic County has historically ranked near the bottom of New Jersey’s counties for health outcomes. With an organization as great as AtlantiCare, that’s not acceptable. Life expectancy in our region also trails the state average.
So we look at our clinical assets and capabilities, where our care gaps are and how those intersect. Then we build additional capabilities where possible. We redefine our work around social determinants of health and bring in external stakeholders. We know housing insecurity, food insecurity and other social determinants affect life expectancy. We look at public safety with law enforcement and our partners. We identify the key factors that will move those numbers and the specific interventions that can make a difference.
That goes for our homelessness and housing insecurity work. We’re not doing all of this by ourselves, and that’s the key message I would share with other healthcare leaders. We can’t do it all ourselves. But if you bring together organizations with the right expertise, align them around the goal and show them why it matters, you can make progress.
Q: AtlantiCare’s AI documentation tool cut physician documentation time by more than 40% in early testing. What has it taken to move from pilot to everyday use, and what are you measuring now?
MC: The core measurement stays the same: how many minutes we’re returning to physicians. We talk about burnout as being overworked, and I think that’s part of it. But burnout is also systemic. It’s about spending time on things that aren’t aligned with why people entered the profession.
Physicians and caregivers are here to take care of patients, not spend so much of their time on documentation. That AI tool is incredibly important because it’s returning 66 minutes a day to physicians. Then what do you do with those 66 minutes? You don’t turn it into a productivity tool for the health system and say, “You need to see five more patients.” We’re going to give that time back to patient care and to the provider.
Taking it from pilot to everyday use, you have to keep everybody involved, particularly caregivers. They need to feel they have a voice in the technology. I keep the questions consistent: What problem are we trying to solve? Why are we using it? How does it benefit the patient, the provider and the caregiver?
Above all, healthcare is highly human. How do we make sure it remains that way, and that technology augments our care rather than overtakes it?
Q: You’ve built cancer care, medical education and rehab largely through partners. How do you decide when to partner versus build yourself, and what makes those partnerships work?
MC: There’s a standard playbook we look at. First, you have to make sure you’re culturally aligned. Everybody has to be working toward the same outcome and willing to work through the process together.
When you look at institutions like Cleveland Clinic, they’re focused on world-class care. With Temple’s medical school, the quality of graduates they place into the industry aligns with what AtlantiCare is trying to achieve. So we have those cultural conversations long before the business conversations.
Then the business considerations have to line up. How does it affect patients and caregivers? Can we build it ourselves? Do we have the time? What would it cost? Why would we partner rather than build it?
If time is of the essence because there’s a care gap that needs to be filled, we would look for a partner. If we have time, subject matter experts and the right capabilities, we might build it ourselves. But many of these initiatives take significant capital and time, so it makes sense to find a partner that has done it before and is aligned with where we’re going.
Q: With Medicaid funding under pressure, how is AtlantiCare preparing for potential cuts, and what are you telling policymakers?
MC: Over the next two years, as part of Vision 2030 and our fiduciary responsibility, we’re working on a program called Thrive. You’re probably the first person outside the organization to hear that.
We’re going to look at how we reduce our cost structure while making sure patients receive world-class care, our teams are appropriately compensated and have opportunities to grow, and the system remains financially sustainable and able to invest in its mission.
In an ideal world, you’d try to get to Medicare rates. I don’t know if that’s achievable, given the scope of what we’re being asked to do. But I do know that even if we fall short, we’ll be in a far better economic position to maintain stability. That’s the big initiative.
As for our conversations with state and federal officials, we understand the need to address healthcare spending. The question is how we use those resources more effectively to deliver care in the right settings.
AtlantiCare is fortunate to own a federally qualified health center, where we care for a largely uninsured, Medicaid and underserved patient population. We see the benefits of having stronger connections between patients and their care teams, including helping patients stay engaged with their visits and prescriptions.
We really have to look at how we’re delivering care. I don’t think we’re going to get there with incremental change alone. There have to be big swings and big transformation. We’ve seen pilot programs and efforts to change care delivery, but the question is whether they’re creating enough forward movement to make substantive change. I don’t think we’ve seen that yet.
I think it’s time for big, transformative change.
Q: You’ve said departures have dropped and recruiting has improved. What made the biggest difference, and how does the medical school fit into your long-term workforce plan?
MC: I have to give a huge shoutout to our nursing and HR leadership. They’ve done an incredible job with our internal university and workforce development efforts. First-year retention for new graduate nurses is 98%, with turnover at 2%. Nursing has become much more stable, our use of agency staff has been minimized and workforce satisfaction has increased substantially.
So we built on that work and asked, what’s the blueprint? Great educational resources and great leadership. That’s really what Temple is all about. Bringing the medical school here will educate the physicians of the future. It will also have socioeconomic and educational benefits for the region.
We want those physicians not only to be educated here, but to live, work, play and stay here. It’s a long-term investment. It could be 15 to 20 years before you fully feel the impact, but that’s what health systems are built to do. They’re built to play the long game and change the region.
We’ve also made significant progress in workforce satisfaction, retention and recruitment. We’ve brought in new clinical leaders from institutions such as Johns Hopkins, Mount Sinai and NYU Langone.
We’re seeing changes in what employees want from their careers, including stability, a connection to mission and opportunities to grow. It’s more important than ever that we provide those opportunities, support our employees financially and educationally, and help make this a great place to live and raise a family.
Q: What’s one thing you’d tell other CEOs to start doing now to be ready for the next three to five years?
MC: Healthcare leaders across the nation have to be truly invested in transforming care. They have to take the big swings and the big risks. It’s time. We have to get our boards aligned and build support for that transformation, because we’re getting close to an inflection point.
Institutions that have the capability to support other institutions are going to be critical. But investment in our people during this transformation is going to be critical, too.
I always say this: In times of transformation and significant change, you sometimes have to sacrifice the numbers to care for your people. If you ask your people, as we ask the people of AtlantiCare, to transform the organization, you have to support them, and sometimes that comes at the sacrifice of the numbers.
That has to be a priority for the health systems that can afford to do that over the next two to three years.
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