By Tobi Elkin
Continuous change is the new norm in healthcare and staying ahead is a full-time job. Hollyse Cooper has worked as a practice administrator since 1993, including serving 11 years at the Charlotte, N.C.–based OrthoCarolina Hand Center, an orthopedic practice with expertise in hand, foot and ankle, hip and knee, shoulder and elbow, spine, sports medicine, and pediatric treatment. OrthoCarolina has 39 locations throughout North Carolina.
During the course of her career, Cooper has held a wide variety of roles in the healthcare field ranging from respiratory therapist to medical equipment rep and physician recruitment for a large healthcare network before finding her niche in practice management.
Cooper spoke to Continuum about the challenges and rewards of her holistic and data-driven role.
Tobi Elkin: What does a practice administrator do in a group like yours?
Hollyse Cooper: I manage the entire operation, including all staffing and personnel issues — hiring and terminating; employee engagement, which is an ongoing challenge; budgeting and managing expenses; helping facilitate revenue generation; supporting clinicians so they can focus on patient care and leading physicians through the transition. Physicians, like most people, are not wild about change. They have to be in compliance with government mandates on meaningful use and other things.
As a practice administrator, my job also entails budgeting, team-building, and managing every aspect of the practice. I currently oversee a staff of 38, which includes surgeons, physician assistants, orthopedic technicians, medical administrative assistants, and more.
Tobi Elkin: What are the biggest challenges for you in this role?
Hollyse Cooper: Lately, it’s the mandates coming down for Meaningful Use, which is essentially the data that all providers are required to capture at each patient visit. It’s everything that’s entered into the EMR (electronic medical record), making sure that we’re in compliance and have the resources in place to roll things out. Resource management is always an issue.
Tobi Elkin: To what extent are you responsible for revenue generation?
Hollyse Cooper: I enable the revenue to be generated because I’m responsible for the operation and making sure we’re efficient. But it’s really a team effort. The physicians themselves are conscientious about how they work.
We’re also incentivized by OrthoCarolina. Metrics are set for us each year, and we manage to those metrics, which may have to do with wait times, meaningful use, managing to collections, making sure we obtain co-pays, and past-due balances.
For example, one metric is for the live answer phone staff to answer 75 percent of incoming calls live and achieve a less than 7 percent abandon rate, which is when people hang up. That metric used to be 70 percent or higher, and the abandon rate was 8 percent or less. So the metrics have shifted, but if you’re managing to them, it shouldn’t be too big a problem.
Tobi Elkin: What are the biggest challenges in your role?
Hollyse Cooper: Managing [patient] no-show rates and same-day cancellations are challenges. We try to come up with ways to reach out ahead of time to people. I have a dashboard that I heavily rely on and run reports twice a week so we can identify each patient who’s been a no-show. We do reminders and live calls.
We have a no-show rate between 10 percent to 11 percent, which when you’re seeing 30,000 patients a year, you’d like to whittle that number down. We try to be proactive.
We have a no-show rate between 10 percent to 11 percent, which when you’re seeing 30,000 patients a year, you’d like to whittle that number down. We try to be proactive.
Wait time is another challenge. We’re addressing it by having patients go through a secure portal to complete paperwork and information that goes into the EMR ahead of time.
We have a huge number of surgeries here, and it was time-consuming to juggle all the scheduling. I was able to secure a sixth person to handle scheduling for tests to relieve the other five schedulers of that shared responsibility.
Another challenge that I’ve addressed is scheduling. For example, we had five testing and surgery schedulers for all the physicians. It was unwieldy and at times unmanageable. We have a huge number of surgeries here, and it was time-consuming to juggle all the scheduling. I was able to secure a sixth person to handle scheduling for tests to relieve the other five schedulers of that shared responsibility. Our surgery schedulers were able to become more efficient because they were freed up from scheduling tests.
Yet another example is the process of check-in and check-out. We now have dedicated staff to register and release patients faster.
Triage has been challenging — we have a four-day-per-week certified medical assistant who’s focused only on triage, which is answering medical questions when people call in post-op.
Tobi Elkin: What tips can you share with other practice administrators who are looking to up their game?
I would say look at the data. Whenever we request another resource, there’s always data from the dashboard to support a business case around the need for additional resources.
Hollyse Cooper: I would say look at the data. Whenever we request another resource, there’s always data from the dashboard to support a business case around the need for additional resources.
With respect to employee engagement, you ideally want employees who are upbeat and enthusiastic about coming to work! That requires a team-building skill set and an understanding of how to make employees feel valued and appreciated. You want people to see themselves as part of a team.
I have an intuitive management style — I’m in tune with the staff. We work with each other; they don’t work for me. I don’t treat any one person differently. I’m like a mother bear with my cubs. We try to make sure that employees’ hours are appropriate for us and for their needs as well. We have some flexible physicians; others are not so much. Overall, we have very little turnover. We’ve had terminations, but the employees understand if they’ve been terminated, they’ve fired themselves!
Tobi Elkin is a veteran content creator and consultant who enjoys crafting compelling narratives for diverse audiences. Based in New York City, her writing has appeared in newspapers, magazines, and on websites including Advertising Age, AOL, the Associated Press, CMO.com, Narratively, Robb Report, The Huffington Post, and many others. She has consulted on thought leadership, marketing, and content strategy for technology firms, consumer brands, and non-profit organizations.
