The education of a medical practice administrator.

1. William F. (Bill) Cockrell, FACMPE
MGMA - Huntsville
November 13, 2012

2. What’s been beaten into
me over the past 31 years.

3. About Me:
 Personal
 58 years old, married, three sons and one daughter-in-
law, live in father-in-law, part time live in mother
 BS in Accounting and Management – Samford
University
 MBA - UAB
 First practice in 1981
 Involved in MGMA
 FACMPE

4. About Me:
 Experience
 65 practices
 500 physicians
 1,400 employees
 Start ups
 Mergers
 Demergers

5. About Me:
 Experience
 Operations
 Human Resources
 Buildings
 Services
 EMR
 Etc.

6. About Me:
 Started my company in 2007
 Full time in 2010
 It was time
 Cockrell and Associates, LLC
 Strategic planning
 Operations design
 Governance
 Human Resources
 Data

7. My wife and the German sum it up.

8. Do You Like Your Job?
 “Heck no. The doctors are crazy and
the employees are crazy. If something
goes wrong I get all the blame and if
something goes right, I get none of the
credit. On the other hand, it’s never
boring.”

9. Life experiences – the jeep, the
scooter and the gorilla

10. Confessions and Lessons
 I thought I was in control
 Ha Ha - Expect the Unexpected

11. The Jeep

12. The Blizzard of 1993
 13 inches of snow
 No power for up to 10+ days
 The Comedy Club in Birmingham Burned
 Along with the Princeton Healthcare Services
Greensprings Clinic
 85% of patient records recoverd – before the days of
EMR

13. Other Proof
 The sink fell of the wall
 The IRS is here
 Because I said so doesn’t work

14. Stay cool
 Unless a someone's life is at stake, you can probably
sleep on it
 Have a plan
 If you don’t have a plan – make one
 Get help if you need it
 Crises need leaders

15. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time

16. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 I thought change was slow
 Change is constant

17. Operations Then
 31 years ago
 Usual, Customary and Reasonable (UCR)
 Patients pay and file claims
 Few health plans / no PMD

18. Operations Now
 PMD and many, many others
 Technology
 EMR
 ACA
 HIPAA

19. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt

20. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 I thought people always tried to do the correct thing
 People do crazy things

21. The Scooter

22. Dealing with Staff
 HIPAA violations
 Substance Abuse
 Lying
 Getting Along

23. Dealing with Doctors
 Coding
 Harassment
 Substance Abuse
 Other

24. Help Is Available
 MGMA – The people in this room
 MASA
 Books

25. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan

26. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 This is the easiest job in the world
 Running a business like this is difficult

27. The Complexity of the Business of
Healthcare
 Direction
 No matter how important the organization is to
you, someone else owns it and they get to make the final
call
 Our job
 Gather and provide the best information
 Hire the best staff you can
 Collect the money
 Run things as efficiently as you can
 Help them have a plan
 What do they want
 What is facing them – good and bad

28. The Complexity of the Business of
Healthcare
 External
 Patients
 Payers
 Competition
 Regulations

29. The Complexity of the Business of
Healthcare
 Internal
 Staffing
 Clinical
 Billing
 Operations
 And a million other things in addition to being a
cheerleader

31. The Complexity of the Business of
Healthcare
 Organization
 There are no problems that three or four well placed
assassinations will not solve
 But
 Effective communications can go a long way to finding a
solution to most problems
 Still, sometimes, it’s just not the right fit

32. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 Running a business like this is difficult – Make sure
you have the right resources and support

33. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 Running a business is difficult – Make sure you have
the right resources and support
 I thought this is a business
 It’s about the patients

34. Our Job
 To make it possible for everyone else to do their job –
 Taking Care of the Patients

35. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crzy things – Have a plan
 Running a business is difficult – Make sure you have
the right resources and support
 It’s about the patients – Care You are a loved one will /
are will be there. It’s why we are here.

36. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 Running a business is difficult – Make sure you have
the right resources and support
 It’s about the patients – Care You are a loved one will /
are will be there. It’s why we are here.
 I thought – “What about me?”
 It’s about us too

37. You
 Keep things in perspective
 The Traveler’s Gift – Andy Andrews
 The buck stops here
 I will seek wisdom
 I am a person of action
 I have a decided heart
 Today I will choose to be happy
 I will greet this day with a forgiving spirit
 I will persist without exception.

38. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a
time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 Running a business is difficult – Make sure you have
the right resources and support
 It’s about the patients – Care You are a loved one will /
are will be there. It’s why we are here.
 It’s about you – Take care of yourself

39. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a time
 Change is constant – Learn to adapt
 People do crazy things – Have a plan
 Running a business is difficult – Make sure you have the
right resources and support
 It’s about the patients – Care You are a loved one will / are
will be there. It’s why we are here.
 It’s about you – Take care of yourself
 I have learned
 People will keep doing crazy things

40. The Gorilla

41. Confessions and Lessons
 Expect the Unexpected – Deal with it one step at a time
 Change is constant – Learn to adapt
 People do stupid things – Have a plan
 Running a business is difficult – Make sure you have the
right resources and support
 It’s about the patients – Care You are a loved one will / are
will be there. It’s why we are here.
 It’s about you – Take care of yourself
 People will keep doing crazy things - Keep things in the
right perspective and LAUGH as much as you can

42. Resources
 MGMA
 ACMPE
 MASA
 Specialty Organizations
 Surveys
 Benchmarking
 Best Practices

43. Resources
 Books
 Adapt – Why Success Always Starts with Failure – Tim
Hartford
 The Creative Destruction of Medicine – How the Digital
Revolution will Create Better Healthcare – Eric Topol
MD
 The Total Service Medical Practice – Vicky
Bradford, PhD
 The Travelers Gift – Andy Andrews
 www.caahms.com

44. Cockrell and Associates, LLC
(205) 208-0012
(877) 726-0443
bcockrell@caahms.com
www.caahms.com