California Health Care: The Right Road to Travel?

Personal trainers. Property tax rebellion. Sushi. Flower power. It is not difficult to go on with a list of trends that took hold in California and then spread. Some analysts believe that the same pattern prevails in health care. Certainly the prototype HMO, Kaiser Permanente, is a California phenomenon, making the Golden State the cradle of managed care. Across the country, managed care has continued to evolve, changing the risk and power dynamics among purchasers, health plans, and providers. California’s metamorphosis has been notable both for its pace and its magnitude. Whether the rest of the country will—or should—follow its lead will be the question addressed in this Forum meeting.

Jeff Goldsmith, Ph.D., and Michael Goran, M.D., are both consultants who have worked with a variety of healthcare clients on crystalizing and refining their missions, objectives, products, and market strategies. In 1994, the two put together a program called “The California Healthcare Experience: What Worked, What Didn’t, and What You Can Learn From It All” for the San Francisco-based Healthcare Forum. Designed for mid-level managers in the industry, it examined how managed care, integrated healthcare delivery and purchaser activism coexist in a dynamic, increasingly competitive marketplace. With three additional years of observation and analysis, Goldsmith and Goran have agreed to update their presentation for the Forum and to re-cast it in light of current legislative and regulatory concerns, such as the formation of provider-sponsored organizations and Medicare+Choice.

In February, the Forum will sponsor a limitedattendance site visit to northern California with a similar agenda: market development, changing patterns of risk and accountability, successful practices and others perhaps best avoided. While this Forum session will serve as valuable background for those who are part of the site visit, it is designed to provide useable insights to NHPF’s Washington audience as well.

Jeff Goldsmith, Ph.D., is president of Health Futures, Inc. Prior to joining Health Futures, he served as national advisor for health care for Ernst & Young, where he provided strategy consultation to a wide variety of healthcare systems, health plans, supply and technology firms. In 1990 he was the recipient of the Coming Award for excellence in health planning from the American Hospital Association’s Society for Healthcare Planning and he is a three-time recipient of the Dean Conley Award for best healthcare article awarded by the American College of Healthcare Executives. Dr. Goldsmith earned his bachelor’s degree in psychology and classics from Reed College and his doctorate in sociology from the University of Chicago.

Michael Goran, M.D., is a partner in the national health care consulting practice of Ernst & Young, LLP. He is the firm’s national director of managed care for physicians, hospitals, and integrated delivery systems. Prior to joining Ernst & Young, he was a director of one of the largest reinsurance/third-party administrator companies serving the self-funded market and president of the company’s managed care subsidiary. Dr. Goran earned his bachelor’s degree from the University of Chicago and his M.D. from the University of Illinois.

A discussion featuring

• Jeff Goldsmith, Ph.D.
  President
  Health Futures, Inc.

• Michael Goran, M.D.
  Partner
  Ernst & Young

NHPF is a nonpartisan education and information exchange for federal health policymakers.