Physicians' financial planner

Science Article
August 22, 2003

New practice-plan administrator Susan Mayfield focuses on finance so center physicians, providers can concentrate on patients

Susan Mayfield, the center's new practice-plan administrator, reviews budget information with Dr. Marc Stewart, Alliance medical director. One of Mayfield's primary roles is to ensure that providers receive proper reimbursement. Photo by Todd McNaught

By BARBARA BERG

A team of expert medical professionals draws cancer patients from around the world through the doors of the Seattle Cancer Care Alliance.

But keeping the clinic doors open for business requires a skilled crew of a different sort: the administrators at each partner institution who make sure that the infrastructure of the Alliance is sound.

Fred Hutchinson's most recent addition to this team is Susan Mayfield, who in April became the center's first practice-plan administrator. As manager of business operations for center employees who practice at the Alliance, Mayfield's responsibilities touch many aspects of the shared financial relationship between the two institutions.

Her duties include overseeing patient billing and physician-fee reimbursement, conducting financial analyses, planning budgets and providing general support to the center's physicians, physician assistants and nurse practitioners to ensure that their practice needs are met. In addition, she serves as one of the Fred Hutchinson's key financial liaisons to the Alliance partner institutions and UW Physicians, the practice group of which most center physicians are members.

Myra Tanita, the center's executive vice president and chief operating officer, said that Mayfield's position was created to unify the management of responsibilities that previously had been divided between multiple staff members.

"As the Alliance has matured, we realized we could be better served by having one strong individual manage the center's practice," she said. "This is a complex area that has become more so as our financial relationships with other institutions and regulations for billing practices continue to evolve.

"We were very lucky to find someone with Susan's background in practice management, which enables her to be a superb advocate for all of our medical staff in the Clinical Research Division who practice at the Alliance."

Financials first for her

Mayfield said that her role allows the center's physicians and midlevel-medical providers to stay focused on their top priority-taking care of patients with cancer.

"Financials are not usually first and foremost on a physician's mind, but it's critical that billing, reimbursement and budgeting all run smoothly in order for the practice to function," Mayfield said. "It's my job to pay attention to details of the financial aspects of the practice and to make sure that our providers have the tools, training and resources that make it as easy as possible for them to handle whatever financial responsibilities are required of them."

Dr. Marc Stewart, Alliance medical director, said that Mayfield's understanding of the complicated world of health-care finances and reimbursement does exactly that. "We are extremely fortunate to have Susan helping us design our budgets and provide critical reviews of revenues, billing processes and expenditures," he said.

A patient treated at the Alliance-or in any other hospital or clinic-incurs two general types of charges. Fees that cover hospital rooms or use of facilities and nursing time are paid to the institution that provides care, in this case the Alliance. The other set of charges cover fees for a physician's time.

"The processes, revenue and reimbursement associated with physician charges are the areas I'm interested in," Mayfield said. "At the center, in addition to our 75 physicians who treat patients and bill for services, our practice also includes 28 midlevel providers who provide care for our transplant patients."

Roles and goals

Mayfield said that one of her primary roles is to make sure center providers are properly reimbursed for their time. Because the Alliance is a partnership of three institutions-Fred Hutchinson, UW Medicine and Children's Hospital and Regional Medical Center-effective systems must be in place to ensure that each receives appropriate and accurate reimbursement for ser-vices provided.

To enhance existing procedures, Mayfield will facilitate conversations with representatives from the Alliance partners as well learn from other institutions who have developed highly effective financial strategies.

Accurate reimbursement is also critical to budget planning for the Clinical Research Division. Because many division members split their time between research and clinical care, a percentage of their salaries is typically covered by the practice groups-such as UW Physicians-of which they are members.

Originally from Seattle, Mayfield earned a master's degree in health administration at UW before becoming a health-care consultant for Arthur Anderson Consulting, where she focused on operational process redesign within academic hospitals.

After a family move to California, Mayfield became practice manager for the pediatric-oncology clinic at the Lucile Packard Children's Hospital at Stanford University Medical Center. Most recently, she worked with a Boston-area startup company that developed Web-based software to link physicians with insurance companies.

Though her new job at the center requires her to wear multiple hats, Mayfield relishes a challenge.

"I enjoy having a variety of different projects," she said. "There are a lot of opportunities for enhancing our existing processes. I look forward to working with people at the center and with our collaborators to make that happen."

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