President and CEO, The Regional Medical Center of Memphis

Almost a year to the day of Reginald Coopwood’s assuming The Regional Medical Center at Memphis’ top leadership role last March, the announcement appeared in US News & World Report that included “The Med” among the top hospitals in the metro area.

The Med ranked fourth out of 25 hospitals in metro rankings in Memphis and the surrounding areas. Its gynecology specialty placed The Med among “high performing” organizations and the hospital also received high marks in patient safety and the level of its nursing staff.

There was much speculation about who would assume the challenge of taking the helm at such tumultuous times for the hospital, affectionately known as “The Med.” Enter Reginald Coopwood, MD, who approached the task with his eyes wide open and a mind receptive to the possibilities of making the hospital one of the premier facilities in the city. To say that he likes a challenge would be an understatement, as those who are familiar with The Med’s history know only too well.

When Coopwood visited The Med as a candidate for CEO, he noted that it didn’t have much going for it, with threats to its continuing existence due to its fiscal health. He knew the value of The Med to West Tennessee and the surrounding states and “What I found is an organization that had been through a lot of leadership transition, and was in the process of going through a lot of change and public scrutiny around its fiscal health,” he said.

But what impressed and struck a chord with Coopwood was its staff – the strongest asset any organization possesses. They were loyal and dedicated to the mission, though not particularly happy campers. “You had a group of people who believed in The Med and its mission and, if The Med was going to close, they would probably be there doing their jobs until the last day. People were not jumping ship. There was not a brain drain because The Med was threatened – people felt it was an asset to the community. You can’t buy or create that. To me, that was a great foundation (to build on) in order to make some changes.”

He recognized the opportunity to recruit a competent executive team to complement the strong employee base. A chief legal counsel, Tish Towns, and a VP of external affairs, Monica Wharton, had already been hired. With plans to hire a CFO, a COO, a CNO and a CMO, Coopwood set about pulling together his leadership team. “With those things coming together along with support from the county, we were able to finish the last fiscal year (2010) with a bottom line of approximately 5 million. The previous year ended with a 20 million loss.”

This was cause for celebration and a far cry from the headline posted October, 2009 in the Commercial Appeal: “The Regional Medical Center at Memphis May Pull Plug on Lifeline: Closing of Emergency Unit Looms Over Funds.”

Coopwood has just begun.

He is a general surgeon by training and practiced with Signature Surgical Group in Nashville where the surgeons covered four hospitals. In 2000 he became the CMO at Metropolitan Nashville Hospital Authority and in 2005 was named CEO where he served until March 1, 2010 when he accepted the top position at The Med. A combination of a physician’s training and hospital executive experience positions him to lead the effort to improve The Med’s financial status and overall operations.

When asked about strides made thus far, Coopwood said, “That success is a combination of the expense control of the interim management that the board had brought in, which was significant, and we started to change the hospital’s image and to build revenue on top of well-managed expenses. We have been very successful year-to-date and continue to generate revenue. We will finish this year in the black. We have a stronger budget than last year and expect that (trend) to continue.”

Coopwood’s plans are to first create a strong fiscal organization, coupled with making a large investment in the revenue cycle. Increasing efficiencies are allowing for capture of dollars which historically have not been collected. “There has been a slight improvement in payer mix but it’s essentially the same book of business… When you have that revenue cycle you are capturing the dollars. That has to be a well oiled machine and this effort is being lead by Rick Wagers, CFO.”

When asked how more dollars are being captured, Coopwood responded, “In many ways…better coding, better billing, capturing charges for high end complex work performed in areas such as the Firefighters Regional Burn Center, the High Risk Obstetrics unit, the Sheldon B. Korones Newborn Center, and the Elvis Presley Memorial Trauma Center. Those areas need to be closely looked at to make sure charges are appropriately entered. It’s really reconfiguring and reengineering the revenue cycle.”

The second most important task, according to Coopwood, was to bring in an operating officer who could reengineer process. “What you had here is an organization where there had been a lot of work force reduction. Reduction of the work force may be the right thing to do for the bottom line but it you don’t reengineer how people do their work (the process), you end up hurting the organization.”

“We have taken a lot of the inefficiencies out of the process. Our COO, Robert Sumter, is leading that effort and we have several Six Sigma black belt projects going across the organization, reengineering the work flow to improve efficiencies,” he said.

Because of his experience with public hospitals, Coopwood understands that generally they cannot compete with privately owned hospitals. He would like to reverse that trend at The Med so that they can compete for patients. Noting years when there was no investment in the physical plant due to fiscal constraints, Coopwood said they painted and cleaned up and eliminated the shared rooms. “It’s an environment that’s no different from other places. We invested in the physical plant and that starts to make people feel better – and it makes people care more. Attitudes started changing and it’s just been a fun thing to watch.”

A recent visit from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) gave The Med a favorable report that thrilled Coopwood, noting comments about the staff and the facility’s cleanliness.

After operations and the physical plant, Coopwood began to address quality. “We’ve put a lot of effort into quality because the value is low cost, efficiency and high quality.”

How does Coopwood feel about health reform and how it might affect The Med? “I strongly feel that we need more than just payment reform. We also need to reform how we deliver care, and that’s something we are focused on – the mode, the methods, even if it means that I have less beds. It’s really the right thing to do. We need to focus on how to keep people healthy and out of the hospital. Those are the things that will really affect the curve of healthcare costs.”

How does he like Memphis? “I was born and raised in Nashville so it’s all I knew. All my professional and social connections have always been there…so there was some degree of fear moving to this city. But it’s has been very embracing. It’s a great town…great restaurants, great community, and great people, so I am a Memphian now. When I go back to Nashville for meetings…it’s not home now. They don’t have the river. There’s a lot more culture here and there’s something about this city…”

Coopwood has five children: three grown sons 26, 22 and 19, and two little girls, 5 and 2. His wife is an attorney who has temporarily suspended her law practice and is at home in “full time practice” with the little girls. He works in the yard and plays golf for fun and favors historical and political reads. “I moved to Memphis in the midst of the mayoral race so I was baptized here by fire,” he claimed. He diplomatically commented about Memphis’ local politics, as “interesting… an interesting community.”

Coopwood has just celebrated his first year anniversary at The Med.

What a difference a year can make.

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