KAREN F. TARANTO
Principal

Ms. Taranto is a successful executive with more than 30 years of experience in the health care field. She has specific expertise in the development and administration of managed health care systems, specializing in operations. As co-founder of pmpm® Consulting Group Inc., established in 1994, Ms. Taranto serves a national clientele, working with physicians and physician organizations, hospitals and integrated delivery systems, health plans, public and community-based health care entities, and other health care professionals.

Ms. Taranto’s experience includes senior level positions in hospitals, Health Maintenance Organizations, Independent Practice Associations, and Physician Management Companies. She was Founder, President and CEO of Managed Care Systems, Inc., a physician administrative service bureau for 2,000 physicians and 85,000 HMO members in six IPAs in northern California. With annual IPA revenues of $40 million and a staff of 100, MCS was the foremost physician management company in California. Ms. Taranto was previously Executive Director of Sacramento Physicians Medical Group Network, then California’s largest IPA extending to four counties and 1,200 physicians, in a joint venture with American River Hospital in Sacramento. Her earlier health care experience includes obtaining federal grant funding to develop and operationalize a community-sponsored HMO. She obtained federal qualification for this HMO where she served at the senior executive level for eight years. She started her health care career as a Research Associate working for the Children’s Hospital of Pittsburgh, Pennsylvania, participating in a four-year longitudinal study of infant accidents and child abuse. She has also conducted research for the Department of Physical Medicine and Rehabilitation at the School of Medicine at the University of California at Davis.

Through these diversified health care leadership roles, Ms. Taranto has acquired an experience base that includes the full range of activities associated with the development and management of MSO, PHO, and IPA entities. She has specific expertise in the building and implementation of utilization and quality management programs, provider and member services departments, business office functions including claims adjudication and revenue recovery operations, and evaluation, selection and oversight of the installation of management information systems. This expertise encompasses not only the technical development of structures, policies, procedures and practices, but also the education and support of the physicians and staff who must implement and manage these processes. Her consulting practice extends to analyzing and negotiating both risk-based and non-risk agreements, providing strategic direction regarding risk partnering and presenting options and recommendations in the framework of the regulatory environment. Ms. Taranto’s breadth of expertise is often applied in “turnaround” situations where provider organizations are in need of operations analysis, strategies and work plan development and implementation oversight with a goal of stabilizing operations and financial performance.

Ms. Taranto also has direct hands-on experience with the development of complete
Knox-Keene licensure applications, as well as the direction and oversight of the entire filing process. Ms. Taranto’s vast managed care experiences and tenure in the industry enable her to effectively fill the role of expert witness in matters related to health care.

Ms. Taranto is a member of the Turnaround Management Association, the American Association of Health Plans, the Medical Group Management Association, and the Society of Professionals in Healthcare, and is an affiliate of the California Healthcare Association. She is a past president of the Healthcare Executives of Greater Sacramento, and has been associated with Healthcare Financial Management Association and American Managed Care Review Association. Ms. Taranto was a founder and Board Member for the Sacramento Child Abuse Council and has been active on a variety of community health and education Boards and Councils.