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

2. Whats been beaten intome 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, its 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 doesnt work 14. Stay cool Unless a someones life is at stake, you can probablysleep on it Have a plan If you dont 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 atime 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 atime Change is constant Learn to adapt 20. Confessions and Lessons Expect the Unexpected Deal with it one step at atime 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 atime 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 atime 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 ofHealthcare Direction No matter how important the organization is toyou, someone else owns it and they get to make the finalcall 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 ofHealthcare External Patients Payers Competition Regulations 29. The Complexity of the Business ofHealthcare Internal Staffing Clinical Billing Operations And a million other things in addition to being a cheerleader 30. The Complexity of the Business ofHealthcare Organization There are no problems that three or four well placedassassinations will not solve But Effective communications can go a long way to finding asolution to most problems Still, sometimes, its just not the right fit 31. Confessions and Lessons Expect the Unexpected Deal with it one step at atime Change is constant Learn to adapt People do crazy things Have a plan Running a business like this is difficult Make sureyou have the right resources and support 32. Confessions and Lessons Expect the Unexpected Deal with it one step at atime Change is constant Learn to adapt People do crazy things Have a plan Running a business is difficult Make sure you havethe right resources and support I thought this is a business Its about the patients 33. Our Job To make it possible for everyone else to do their job Taking Care of the Patients 34. Confessions and Lessons Expect the Unexpected Deal with it one step at atime Change is constant Learn to adapt People do crzy things Have a plan Running a business is difficult Make sure you havethe right resources and support Its about the patients Care You are a loved one will /are will be there. Its why we are here. 35. Confessions and Lessons Expect the Unexpected Deal with it one step at atime Change is constant Learn to adapt People do crazy things Have a plan Running a business is difficult Make sure you havethe right resources and support Its about the patients Care You are a loved one will /are will be there. Its why we are here. I thought What about me? Its about us too 36. You Keep things in perspective The Travelers 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. 37. Confessions and Lessons Expect the Unexpected Deal with it one step at atime Change is constant Learn to adapt People do crazy things Have a plan Running a business is difficult Make sure you havethe right resources and support Its about the patients Care You are a loved one will /are will be there. Its why we are here. Its about you Take care of yourself 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 theright resources and support Its about the patients Care You are a loved one will / arewill be there. Its why we are here. Its about you Take care of yourself I have learned People will keep doing crazy things 39. The Gorilla 40. 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 theright resources and support Its about the patients Care You are a loved one will / arewill be there. Its why we are here. Its about you Take care of yourself People will keep doing crazy things - Keep things in theright perspective and LAUGH as much as you can 41. Resources MGMA ACMPE MASA Specialty Organizations Surveys Benchmarking Best Practices 42. 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 43. Cockrell and Associates, LLC(205) 208-0012(877) 726-0443bcockrell@caahms.comwww.caahms.com