As health industry shifts, new faces in Who's Who.

Charles Adams Chairman and CEO Chad Therapeutics Inc.

Charles Adams founded Chad Therapeutics Inc. in 1983 based on an idea brought to him by three friends. The idea was a device that delivers oxygen only when the patient inhales (rather than continuously).

Today, those friends are rich on royalties from their product, called the Oxymatic, that allows oxygen to be toted around in a smaller cylinder.

As chairman and CEO of Chad Therapeutics, Adams has overseen rapid growth of this and other respiratory care equipment. The company reported net income in fiscal 1997 of $5 million vs. $4.3 million a year earlier. Revenue was $27 million, a 35 percent improvement over the previous year.

Adams, who will turn 70 in September, is not ready to stop there. He says that a new product developed by his company will "probably be the greatest advance in home respiratory care in a decade." He can't talk specifics, but it likely will be marketed come October.

James Barber President Healthcare Association of Southern California 

The son of a dentist and brother of a physician, James Barber prefers managing medicine over practicing it.

He was appointed to his current post in 1994, overseeing the influential and highly visible lobby for most of the region's hospitals.

Just 40 at the time of his appointment, Barber already had a wealth of experience running hospitals, and was only the organization's fourth president in 71 years.

Since his appointment, Barber has steered the group through several major changes. Formerly the Hospital Council of Southern California, the organization's name was changed to reflect a more diverse membership, which now includes integrated hospital-physician group systems as well as independent hospitals.

HASC also has been a vigorous voice in the debate over the proposed replacement of L.A. County-USC Medical Center and the level of reimbursements that providers will receive as the county moves its Medi-Cal population into health maintenance organizations.

Robert Beltran Board Member Latino Health Care

Robert Beltran, a practicing surgeon who spends about 20 percent of his time on administrative affairs, is looking to ensure that the Latino community receives adequate health care.

Beltran tries to do that through his position with Latino Health Care, a network of physicians, hospitals and health plans that serve Latinos in Southern California.

As physician advisor to the Latino Coalition for a Healthy California, Beltran also has met with state health officials to ensure that Latino Medi-Cal patients in managed-care programs are receiving good services.

In addition, he meets with National Quality Review organizations, such as the Foundation on Accounting, to help them understand the needs of underserved, low-income Latino patients.

Robert Brook Director, Health Sciences Program Rand Corp.

Health plans and providers have been scrambling to become more responsive to patients in recent months, largely due to pressure from elected officials and patient advocates. That pressure is coming in reaction to an avalanche of studies that have scrutinized managed care from every conceivable angle.

Few, if any, have been scrutinizing more than Robert Brook.

In his position at Santa Monica-based Rand Corp. - one of the country's leading research institutions when it comes to health care quality - Brook was part of the seminal Health Insurance Experiment and co-principal investigator on the Health Services Utilization Study.

The 15-year "experiment" involved 2,700 families randomly enrolled in a variety of health insurance plans to ascertain the plans' effectiveness. The utilization study led to development of a method of assessing the appropriateness of care that could be applied to various specialty medical procedures.

"We get involved in everything from drug and alcohol addiction to how managed care should be reorganized to how clinical care should be provided," Brook said.

Erich Burkhart Principal Lee, Burkhart, Liu Inc.

Erich Burkhart, who has spent 21 years designing health care facilities throughout Southern California, says his current project is his most fascinating one yet. Burkhart is the lead executive architect for the UCLA Academic Medical Center, a replacement of the school's existing medical center that was damaged in the 1994 Northridge earthquake.

As such, he is responsible for managing the project. "It's rare to have the opportunity to completely replace an academic hospital," says Burkhart, "It represents a tremendous opportunity to design a state-of-the-art hospital."

Burkhart said the hospital will be designed to house the latest medical equipment - and to be functional after a major quake.

"If you don't anticipate technology, you can't provide the proper space or outlets or utilities needed," he says.

Burkhart should know the intricacies of hospital design by now. He is executive architect on the proposed County-USC Medical Center, which would be built directly adjacent to the existing County-USC facility. He has also designed seven health care campuses for Kaiser Permanente, five health care facilities on the University of California campuses and several military hospitals.

- Lisa Steen Proctor

Victor Chaltiel Chairman, President and CEO Total Renal Care Holdings

'It's not every health care provider that gets profiled in Financial World magazine, but Victor M.G.

Chaltiel has managed to create a company that's on the cutting edge of financial performance and the cutting edge of health care.

Financial World called Torrance-based Total Renal Care Holdings Inc. an undervalued stock and said its prospects are brighter than those of its top two competitors. It was another distinction for a firm that is already the country's third largest and fastest growing provider of dialysis and related services for patients suffering from chronic kidney failure - and is ranked 16th on the Business Journal's recent List of fastest-growing public companies.

Total Renal Care's zooming fortunes are the result of an aggressive growth strategy by Chaltiel, a 30-year veteran of some of the most prominent companies in health care who assumed the top post at the company in August 1994.

Chaltiel's company plans to develop 15 new kidney dialysis centers this year, and has about $300 million in cash for acquisitions.

Frank Clark Executive Vice President Los Angeles County Medical Association

When L.A.-area physicians take a collective and, it's usually orchestrated by Frank Clark, the chief staff person in charge of working with LACMA's more than 8,000 members.

As Southern California's managed care market consolidates and government payers tighten purse strings, physicians are turning to associations like LACMA for information and support.

LACMA is the lobbying and industry affairs organization involved in nearly every issue that affects doctors and their patients.

"Doctors are under a great deal of stress, with all the volatile changes going on," Clark said. "They're concerned about their clinical autonomy and about their ability to act as a profession. And most of all, they're concerned about the quality of care they can provide for patients."

Prior to joining LACMA, Clark was a top executive with Blue Shield of California and was communications director at the California Medical Association.

Thomas Collins President and CEO Memorial Health Services

Establishing a brand-name identity works for everything from laundry detergent to luxury automobiles. Now Thomas Collins wants to establish

"Memorial Care" as the standard in the health care industry.

"We're trying to differentiate our organization in the marketplace," Collins said. "We're trying to say, 'This is a different organization.' We want you to select Memorial Care."

Collins is doing this by issuing "report cards" that show how Memorial Health Services hospitals measure up to national standards. If the hospital is found lacking, Memorial officials make improvements, Collins said.

"That's what it's all about, raising the bar in our organization to match or beat these national standards."

Memorial Health Services includes Long Beach Memorial Medical Center, Miller Children's Hospital in Long Beach, and three Orange County hospitals - Saddleback Memorial Medical Center, Anaheim Memorial Medical Center and Orange Coast Memorial Medical Center.

William Colvin Director of Health Facilities Planning Services County of Los Angeles

If former career Army officer and linguist Larry Colvin could fulfill one dream, it would be to replace County-USC Medical Center - a project that was languishing before he began his 20-year military career and remains bogged down today.

Colvin, however, is patient. He waited most of his career for a chance to work in health care after earning a master's degree in management with a specialization in health care at Central Michigan University.

After college, Colvin got sidetracked into a military career, which took him to Vietnam and the Middle East.

He began his career with L.A. County as a "transition manager" in the Chief Administrative Office in 1989, essentially a troubleshooter who reorganized the county's animal care control and children's service departments. He said he signed on to that post with the understanding that he could later move to the county's health department.

Jamie Court Director Consumers for Quality Care

At 30, Jamie Court is the youngest member of the "Who's Who." He is also the only member with a ponytail. It's fitting, given his role as health care's proverbial vegan in the steakhouse.

Consumers for Quality Care, an offshoot of insurance gadfly Harvey Rosenfield's Proposition 103 Enforcement Project, regularly takes HMOs to task for its perception that the plans prefer saving dollars over patients.

"Injustice motivates me," says Court, who has also worked as an advocate for the poor and homeless, "and I've never seen anywhere else the rapacious greed that drives managed care."

Court's methods are unusual for an industry braced by calm rhetoric. Unlike Consumers Union, with its button-down staff of attorneys who speak in wall-measured tones, Consumers for Quality Care is uncompromisingly in-your-face.

Court regularly harangues the corporate practices of HMOs at hearings held by state regulators. He peppers reporters with several press releases a week, drawing a fair flow of ink.

Failing that, Court is not above resorting to media stunts. His most notorious episode occurred at a media session an HMO held for journalists; he dumped a pile of beans in front of presenters to decry the "bean-counting" mentality of the industry.

Paul DeMuro Partner Latham & Watkins

Paul DeMuro may not have a crystal ball, but he has been consistently ahead of the legal pack in developing expertise in areas of health care law before they really take off.

DeMuro represents health care organizations in mergers and acquisitions, managed care issues and claims of Medicare fraud and abuse.

"These three areas ... have started to become very popular," said 43-year-old DeMuro. "And there's not a lot of people with a lot of expertise."

DeMuro was named one of 1996's top 40 health care attorneys in the United States by the National Law Journal and he just finished a term on the national board and executive committee of the Healthcare Financial Management Association, earning the distinction of being only one of two attorneys ever on the board.

One of DeMuro's recent deals involved negotiating an arrangement on behalf of Valley IPA, a large physician group in Modesto, under which another group, Brown & Toland IPA, would provide all necessary management services.

This deal represents for DeMuro one of the most interesting aspects of his job. "I have to be a legal and business architect - working with physicians ... to help them structure transactions that work for them," said DeMuro.

Joe Doyle President and CEO Baxter Gurian & Mazzei Inc.

Joe Doyle, head of what is arguably L.A.'s premier health care ad agency, became interested in the field as a boy in New York delivering prescriptions. He was helping his father, a New York City cop who moonlighted for a local pharmacy.

Doyle, who earned a degree in pharmacy and biology from the University of Buffalo, was first exposed to the marketing side of the business came when he took a job for Eli Lilly and Co.

He made a career turn and took a job at an advertising agency that specialized in campaigns for pharmaceutical companies (which once was where just about all the action was in health care advertising).

BGM's client roster reflects the changes in the health care industry. Hospitals, clinics, health maintenance organizations and other health care organizations hardly advertised at all when he began his career. Today, they represent 40 percent of the agency's business.

"We have seen an incredible surge of advertising dollars being spent to help consumers understand health care products and services," said Doyle, who said that one of the agency's chief objectives is to deliver messages about his clients' products and services in terms that the audience can understand.

Ahmad Enany Executive Director Southern California Biomedical Council

As executive director of the council since its inception a year and a half ago, Abroad Enany has an ambitious dream - creating a united voice for the scattered firms making up the biomedical industry in Southern California.

Ever since Enany, a public policy expert, was pulled from Rebuild L.A. to develop the council, he has pursued this goal head-on. He has been vocal in drumming up support for his fledgling organization not only from local biomed companies, but also from universities, venture capital firms and law firms.

The council currently has 55 member organizations (which pay dues of various amounts depending upon their type and size) and representatives of 25 organizations on its board.

While most of the work done so far has been in the "networking and information area," Enany says the ultimate goal is to "help firms mobilize resources to help make them viable and to solve collective problems such as adequate training of personnel."

Shirley Fanin Director of Disease Control County of Los Angeles

Shirley Fanin has seen some horrendous afflictions during her 20 years as a public health official, including that caused by a mysterious killer virus that was first documented in Los Angeles County in 1981 - HIV.

"It's been a very exciting infectious disease time," said Fanin, a pediatrician turned infectious disease czar for the sprawling county.

But Fanin's tenure also has spanned an era of austerity, with fewer resources dedicated to combating public health threats, the most notorious of which are communicable diseases such as AIDS and tuberculosis.

Fanin said the county has averted catastrophe so far, but cracks could quickly develop in its defense against disease. "I've got a lot of good people working hard to take care of the daily care of things that happen in a population of 9 million," she said. "But we're not making great strides in improving our function for the 21 st century. You don't (build a dam) when the floodwaters are upon you. You build it before the flood."

Mark Finucane Director Los Angeles County Department of Health Services 

Mark Finucane was appointed just last year to oversee one of the largest and most financially strapped public health departments in the country.

Although his last job-was running the much smaller health department in Contra Costa County, Finucane appears on track toward guiding his department to more tranquil financial waters, as well as accomplishing the goal of privatizing many of the department's outpatient clinics.

Intensely focused, Finucane manages to run a half-dozen miles and work 12 hours just about every workday. For the most part he has only seen his Northern California-based family on the weekends (school schedules have prevented them from relocating yet).

Finucane has also shown considerable talents in diplomacy, having been able to go about his business without yet making any sworn enemies with the volatile Board of Supervisors.

Still, Finucane is no pushover. A fan of warrior Sun-Tzu's book "The Art of War," he swiftly dumped a longtime and very popular senior manager when it was discovered the manager had lied about his education on his resume.

Randall Foster Administrator and CEO Martin Luther King Jr./Drew Medical Center

With a recent reorganization and a new trauma hospital due to open in January, Randall Foster has grown accustomed to working 13-hour days overseeing the county facility.

"I get in at 7:30 (a.m.) and somewhere around 8:15 or 8:30 (at night), I start heading for the door," said Foster. who also oversees seven outpatient health centers in the southwest area of Los Angeles County.

About 1 million people live in the service area under Foster's purview.

Foster took over leadership of the troubled hospital in January. 1996 as part of a crisis management team put in action by county supervisors. He won permanent appointment to the position last July.

Services at King/Drew, which despite its troubled past has for years operated a well-regarded Level I Trauma Center. The facility will further improve with the addition of the new trauma hospital. The hospital will cost about $66 million to build and another $14 million to outfit with medical equipment and supplies, Foster said.

Peter Fugelso Chief of the Kidney Stone Service Good Samaritan Hospital 

Dr. Peter Fugelso's pioneering vision of managed care a decade ago has made him a leading rome in the industry.

Fugelso - who specializes in kidney stones and pediatrics - began seeking contracts with HMOs and municipalities in the mid-80s, well before the managed care boom.

Contracts signed years ago and renewed with Los Angeles, Kern, and Ventura counties will bring an estimated 1,800 customers to his practice at Good Samaritan Hospital this year, he said.

As doctors battle for leverage with HMOs and hospitals, Fugelso has been elevated into the role of a spokesman for doctors, said Jim Lott, vice president of the Healthcare Association of Southern California.

"He's got a good, solid business sense and knows how to negotiate well," Lott said. "He's one of the pioneers in contracted medicine."

A board-certified urologist, Fugelso also is a professor of urology at the USC Medical School, which is affiliated with Good Samaritan.

"Many (in the industry) agree that we are running a model program that delivers better care at a lower cost," said Fugelso. "We continued to get contracts, and build up a niche of contracting with places that could direct more business to us."

Michael Gagan Lobbyist Rose & Kindel

Michael Gagan has spent much of the last year bucking the adage, "You can't fight City Hall." Gagan is lobbying on behalf on the five L.A.-based HMOs that are trying to change the city's tax code.

The five HMOs - Wellpoint Health Networks, Maxicare California, CareAmerica Health Plans, Health Systems International and PruCare of California - currently fall under a catch-all provision in the tax code, putting them at the highest tax rate.

Further, Gagan complains, the city's method of imposing a tax on gross receipts is unfair because it doesn't take into account that 85 percent of the receipts are merely passed through in the form of payments to physicians, pharmacists and for other medical expenses.

As one of the city's most successful lobbyists, Gagan was the man the HMOs have turned to. He has spent the past 10 years lobbying City Hall on behalf of his clients, which include many Fortune 500 companies.

Gagan has his work cut out for him in representing the HMOs: He must convince six L.A. city offices that the tax code should be revised for the managed care companies - a task Gagan says is a logistical nightmare.

"HMOs are extremely complex and each is structured differently," said Gagan. "So it's difficult explaining the HMOs' circumstances to the city policymakers. It's also difficult to explain the way the city works to HMOs."

Gagan, however, remains optimistic about his chances of success. He believes that his task, which began last October, will be successfully concluded before the summer ends.

Martin Gallegos California Assemblyman Chairman of the Assembly Health Committee

A chiropractor who was elected to the Assembly in 1994, Martin Gallegos, D-Irwindale, has led the Assembly's charge for HMO reform.

"We're going to be able to make much greater strides in reforming HMOs and managed care because there's such a strong public outcry," he said.

The problem, Gallegos argues, is that "bean-counters" are affecting medical decisions to the detriment of health care.

One of Gallegos' bills, passed into law last year, requires HMOs to have a policy on file with the state Department of Corporations stating guidelines for when a patient may seek a second opinion.

Two more of the assemblyman's HMO bills are pending. One of them would require HMOs to disclose, within five days, the rationale for denying treatment to a patient. The other would require HMOs to provide written reasons for dismissing doctors, and open the process to binding arbitration. The measure seeks to prevent HMOs from dismissing doctors who prescribe costly but need treatment.

"Clearly the inroads that we've made have only begun to chip away at the giant of managed care," Gallegos said.

Malik M. Hasan Chairman and CEO Foundation Health Systems Inc.

Malik M. Hasan heads the nation's fourth-largest-publicly held managed care organization, Foundation Health Systems, which was formed through the merger in April of Foundation Health Corp. and Health Systems International, where Hasan was chairman before the two merged.

The merged entity has 15,000 employees and projected fiscal 1997 revenues of $9 billion. It is headquartered in Los Angeles and also has principal offices in Pueblo, Colo.

Hasan is a former Pueblo neurologist who maintained a private practice until 1992 and whose career in many ways mirrors the rise of managed care.

In 1985 Hasan founded a small, local Colorado health plan called QualMed, which had 5,000 members. Through a series of acquisitions, Hasan turned QualMed into a multi-state health plan with more than 330,000 members and annual revenues of more than $400 million. In 1994, QualMed and Health Net merged to form Health Systems International, which Hasan then expanded substantially as its top executive.

R. Scott Hitt Chairman Presidential Advisory Council on HIV/AIDS 

Just as breakthroughs in AIDS treatment have started to keep researchers and health care providers scrambling to keep up, R. Scott Hitt has emerged as perhaps the nation's leading authority on which treatments are working.

From his perch at Beverly Hills-based Pacific Oaks Medical Group - where he has cared for more than 1,000 AIDS and HIV patients as a member of the nation's largest private practice provider of HIV/AIDS health care services - he also serves on the board of AIDS Project Los Angeles and on the medical advisory board of Search Alliance, an L.A.-based organization that coordinates AIDS research, as well as serving as medical advisor to Positive Living for Us, an informational program for people living with AIDS.

The University of Arizona Medical School graduate says he got involved in President Clinton's first campaign in 1992 as an advisor on AIDS and gay and lesbian issues - especially the importance of nurturing cutting-edge, newer HIV and AIDS therapies.

He got the job, he notes, because of his wealth of hands-on experience.

Before that, he advised former California Commissioner of Insurance John Garamendi and U.S. Sen. Dianne Feinstein, D-California, on AIDS treatment, coverage and other public policy issues.

Carol Jimenez Attorney Long Beach

Carol Jimenez sees a direct conflict between the way HMOs operate and the delivery of quality health care. "By the nature of the system, they have an incentive to deny care," Jimenez said. "The less care provided, the more money they make."

So in recent years, Jimenez has aimed her legal guns at alleged abuses by managed care providers. Jimenez is co-counsel for the plaintiffs in Grijalva vs. Shalala, in which U.S. District Judge Alfredo C. Marquez ruled that the federal government must require HMOs to provide a timely hearing if a patient appeals a denial of treatment.

The plaintiffs in the class action are 4 million Medicare patients enrolled in HMOs nationwide. The federal government has appealed the ruling.

Jimenez was director of litigation and supervising attorney for the Center for Health Care Rights in Los Angeles from 1991 to the end of 1996, when she opened her own practice in Long Beach.

Mandy Johnson Executive Director Community Clinic Association of Los Angeles County

Mandy Johnson heads an organization that aligns 23 of the county's "free clinics," normally stand-alone operations that function with the aid of donations and grants.

Although soft-spoken and unassuming and heading an organization with only four employees - Johnson has a key role in how health care is delivered to low-income residents in the county.

She has been among the primary negotiators for the type of care the clinics provide to residents as part of the various public-private partnerships being set up in conjunction with the Los Angeles County Department of Health Services.

"Altruism is what motivates me, and the belief that low-income people should have easy access to health care," she says.

Johnson's organization functioned on a voluntary basis until 1995, when she secured funding to transform it from an informal advocacy group to a true trade association. She had previously worked as deputy director of the Venice Family Clinic.

Michael Karpf Director UCLA Medical Center, Vice Provost for Hospital Systems

As chief of one of the hospitals ranked "best in the West" in a recent issue of U.S. News & World Report, Michael Karpf is at the center of an effort by big hospitals to adjust to the pressures of managed care.

Karpf points out that managed care organizations are demanding more of everything from hospitals, including more treatment for their members and more wellness programs to prevent disease.

And they want all of this for less money, Karpf said.

His solution has been to attack the problem on three fronts:

First, he has been adding new medical offices in communities throughout Los Angeles, thereby expanding the services and programs UCLA Medical Center offers. (Karpf also has expanded the Westwood-based medical center's reach by adding Santa Monica-UCLA Medical Center.)

Second. he has been implementing new systems to ensure that doctors spend more of their time treating patients and less time on administrative tasks. And third, he has taken a seat on the Governor's Managed Health Care Improvement Task Force.

Peter Kezirian General Counsel California Department of Corporations

At only 33, Peter Kezirian has the distinction of settling the largest quality-of-care case against a health plan in U.S. history.

In his role as general counsel for the state's Department of Corporations, Kezirian oversaw the state's complaints against Western Dental Services and ultimately negotiated the settlement, which involved a legal strategy previously unheard of in quality-of-care cases, said Kezirian.

Not only did Kezerian pursue a fine against Western Dental, he also asked that a court-appointed independent monitor oversee management of the plan - a remedy that had only been used in the past to oversee financially shaky plans.

Kezerian was successful on both counts. Western Dental paid a $1.7 million penalty, and agreed to pay for a monitor to oversee the plan for two years.

Further, Kezirian says, quality-of-care cases had previously been handled on only a case-by-case basis. "In this case, we amalgamated the (quality-of-care complaints) together and improved the lot of 360,000 enrollees," he said.

Since joining the department in 1995, Kezirian has also been involved in two large HMO mergers - Foundation Health's merger with PacifiCare of California and FHP Health Care's merger into Health Net.

Peter Lee Director Center for Health Care Rights

Peter Lee believes health are is the paramount social issue - so much so that he enrolled at USC law school at the age of 33 in order to hone his advocacy skills.

"Health care can make a huge difference in our lives, a service that provides a measure of society, and how society is succeeding," he says. "But as a whole, the health care system has not done a very good job helping patients and consumers. What motivates me is making sure that happens."

The 15-person Center for Health Care Rights is a non-profit group funded by a variety of grants and donations. It also has a contract with the state of California to provide counseling services for Medi-Cal recipients.

The center has distributed detailed studies about the movement of Medi-Cal recipients into managed care. And in Sacramento, the organization recently launched a "rights" hot-line for members of managed care who might be experiencing difficulties with their plans, using ombudsmen to address grievances.

Lee could be considered a voice of reason among a field of advocates who are often more aggressive. "Advocacy work does not necessarily mean adversary work," he says. "There are (health plan) horror stories out there. But they are anecdotes, and we need to get a better sense than just anecdotes to have a handle on the problems and understand what is working and not working in the system."

Gerald S. Levey Dean UCLA School of Medicine

Jobs don't get too much more complicated than the one held by Dr. Gerald S. Levey. As provost of UCLA's Medical Sciences Department and dean of the

School of Medicine since 1994, Levey oversees a medical school, a dental school, eight research units and three hospitals - UCLA Medical Center, UCLA Neuropsychiatric Hospital and Santa Monica Medical Center.

While this may sound daunting, the 60-year-old Levey said he was attracted to the challenge when UCLA recruited him from his former position as a senior vice president at pharmaceutical firm Merck Inc.

"I like a challenge, and to me it was energizing to think of being able to lead an academic medical center of international renown and have the authority to do what is necessary for UCLA to enter the 21 st century," said Levey.

Since coming to UCLA, he has overseen the development of 12 UCLA community medical facilities that provide primary health care, created a human genetics department and gene therapy program, and helped generate major donations.

Michael Madden Providence Saint Josephs Medical Center Providence Holy Cross Medical Center 

After heading up one of the largest hospitals in the L.A. area for three years, Michael Madden was not exactly given time to rest on his laurels. Instead, the 53-year-old CEO of Providence Saint Josephs Medical Center in Burbank was asked to take the helm of an additional hospital after Seattle-based Providence Health Systems took over Holy Cross Medical Center in Mission Hills in May 1996.

"It's been a major accomplishment to bring the two hospitals together." said Madden. "We've ended up with positive bottom lines at both places as of this year."

Madden said decisions were made quickly after the acquisition, sparing the deterioration of the bottom line often experienced by a consolidation.

Prior to heading up the two L.A.-area nonprofit hospitals - which together have annual revenues of $250 million and 3,200 employees Madden had simultaneously run seven hospitals in Michigan for the Sisters of Mercy.

Peter Makowski President and CEO Citrus Valley Health Partners

Peter Makowski has distinguished himself by building Citrus Valley Health Partners into one of the largest integrated health care systems in the East San Gabriel Valley.

But he also has made a name for himself by establishing a community outreach program to team with cities, schools, churches and civic organizations to offer free or low-cost health care for the needy.

"We are working exceptionally hard to empower communities to take over responsibility for their health," Makowski said. "When we get the ball rolling we step back and let the communities take over, and they have. I'm very proud of that."

Citrus Valley's outreach effort has provided everything from health care programs for young mothers and the elderly, to after school programs for children.

Citrus Valley includes a vast network of health care facilities and programs throughout the east San Gabriel Valley, including three hospital facilities, a hospice, a home health agency, a physician-hospital organization, and three medical group management service organizations.

Douglas Mancino Partner McDermott, Will & Emery

Douglas Mancino stays at the heart of health care in Los Angeles by being involved in representing all kinds of health care clients on a wide range of issues.

He has helped provider clients consolidate into physician management organizations: hospitals merge; and health plans develop new products.

He's been recognized by The National Law Journal as one of the nation's leading managed care lawyers and by California Law Business as "one of the lawyers most frequently cited by their peers among California's most prominent practitioners in the tax-exempt and health care fields."

Mancino is also an expert on fraud and abuse and other regulatory, issues.

The 20-year veteran of health care law specializes in the tax and business and transactional aspects of the business. Beyond his actual practice, Mancino spends time as chair of the Exempt Organizations Committee of the American Bar Association's Tax Section. as well as serving on several health care industry boards and associations.

Alfred E. Mann Chairman and CEO MiniMed Inc.

Alfred E. Mann's college training was in math and physics, which he combined with his entrepreneurial drive to create a collection of health care companies on the cutting edge of technology.

One of several companies Mann heads is MiniMed. which markets a slew of products designed to make life easier for diabetics, among them infusion pumps to regulate the level of insulin in the blood and glucose monitors to ensure proper blood sugar levels.

Mann also is chairman of Advanced Bionics. which manufactures and markets muscle-stimulation systems that restore heating to the profoundly deaf. And he founded Pacesetter Inc., a leading heart pacemaker company, and remains chairman emeritus of that company.

He holds the patents to many of the devices he markets, and has established and funded a nonprofit foundation for research into new medical instruments.

Gail Margolis Owner The Margolis Firm

Attorney Gall Margolis is an expert at providing legal services to medical groups - but she is best known for her work with L.A. Care Health Plan, where she serves as chairman.

L.A. Care is the nonprofit half of L.A. County's two-plan model for administering health care to Medi-Cal patients and shifting them from fee-for-service treatment into managed care. As chairman, Margolis helps set the organization's agenda. One goal: increasing enrollment in the plan from its current 200,000 to about 700,000.

In her legal practice, Margolis works with doctors "all along the continuum, providing all legal services of incorporation and negotiation and providing business services on how to position themselves in the market and work with hospitals."

Margolis also has been involved in negotiating novel combinations of medical groups to better function in health care's changing environment. For example, she is currently working on joining home medical equipment suppliers with a large pharmaceutical network, with the ultimate goal of negotiating with health care plans.

Steven Uranga McKane President and CEO The California Endowment

As head of The California Endowment, Steven Uranga McKane has his hands on millions of dollars earmarked to provide medical care for the needy.

The foundation, which already has given away hundreds of grants, was established in 1996 with an initial endowment of $900 million. The foundation was formed as a provision of the conversion of Blue Cross of California from nonprofit to for-profit status. It immediately became one of the country's biggest sources of medical care funds for "the underserved."

Rita Moya, president and CEO of the nonprofit Los Angeles-based National Health Foundation, said the endowment is one of the most important new sources of funding to come along in years for providing medical care to those who can't afford it.

McKane headed a number of health departments and programs before being named head of the prestigious W.K. Kellogg Foundation in 1991. He was recruited to The California Foundation last year when its board sought someone with a background in public health and foundation work.

Frederick Meyer President and CEO Southern California Healthcare Systems

Frederick Meyer has busied himself over the last year leading a growth campaign that has significantly expanded his company's regional role.

Southern California Healthcare Systems acquired Beverly Hospital in Montebello and Verdugo Hills Hospital in La Canada last year, bringing the firm's total number of beds to 1,400.

Growth aside, Meyer said he has continued his work to improve the quality of care provided by Healthcare Systems while reducing costs.

Toward that goal, Healthcare Systems is building a high-tech, high-volume laboratory that will use robotics to run large numbers of tests and speed results to doctors. The company is spending about $9 million on the lab, Meyer said. It is scheduled to be completed in 1998.

"We get better and faster results and, at the sane time, we're lowering the cost per test," he said.

Healthcare Systems' other hospitals are Huntington Hospital in Pasadena, Methodist Hospital in Arcadia and Huntington East Valley Hospital in Glendora.

Michael Milken Founder, Chairman CaP CURE

The 22-month jail term he served for pleading guilty to six securities violations was not the end of the hardships for Michael Milken.

In 1993, shortly after his release from federal prison, the former junk-bond king was diagnosed with prostate cancer. Although his disease is now in remission, Milken was so haunted by the experience - and the death of his father from melanoma - that he founded CaP CURE with the sole purpose of curing prostate cancer, the most common form of cancer among men.

CaP CURE (the Association for the Cure of the Cancer of the Prostate) has become the world's largest private funder of prostate cancer research, donating more than $50 million to various universities and research groups.

While the sum is impressive, and CaP CURE has become renowned for the swift and pragmatic way it handles grants, Milken still believes up to $20 billion must be raised, in a "Manhattan Project" effort, in order to find a cure. Aside from the money, Milken has convinced many well-known figures who have had the disease to speak publicly on behalf of CaP CURE and about the value of regular testing. These include singer Harry Belafonte, Intel Chief Executive Andy Grove, retired Gen. Norman Schwarzkopf and former Sen. Bob Dole.

Mario Molina President and CEO Molina Medical Centers Inc.

Mario Molina is gearing up for tremendous growth in anticipation of his Long Beach company's mainstream Medi-Cal contract, which is scheduled to go into effect in December.

"We roughly expect the company to double in size over the next year, to about 250,000 members," said Molina, who took over as chief executive last December when his father, C. David Molina, died.

Molina Medical Centers is an HMO that provides health services in Southern and Central California through 27 of its own medical offices, and it also contracts with outside medical groups and independent doctors.

Molina said his key challenge has been to upgrade the family-ran operation in the face of rapid growth. The company has new faces in 16 of 21 top management positions.

"Before, my father, my brother (John Molina) and I did a lot of the day-to-day work," Molina said. "We now have a professional management team."

Clyde W. Oden President and CEO Watts Health Foundation

The Watts Health Foundation was created in the wake of 1965 Watts riots. it is comprised of several community clinics, more than 25 community outreach programs and the United Health Plan HMO, which serves the Medi-Cal population and small business.

Under Clyde Oden's direction, the foundation has been more than the sum of its parts. Already the leading health care executive in L.A.'s African American community, Oden who holds graduate and undergraduate degrees in optometry, public health and divinity - has focused on joint ventures in other areas as well. In 1995, a Watts affiliate acquired Family Savings Bank, the third largest minority-owned thrift in the nation. Oden's goal: to create a "community services enterprise" along the lines of the South Korean model, where disparate businesses are tied together to benefit the community.

Oden figures that mixing health care and lending can be a boon for South-Central L.A., Inglewood and other communities.

Thomas Priselac President and CEO Cedars-Sinai Health System

Cedars-Sinai Medical Center has developed a reputation as something of a hospital to the stars because of its Beverly Hills-adjacent location and the stream of celebrities seeking treatment there.

Thanks to the sheer size of Cedars, the largest nonprofit private hospital in the West, Thomas Priselac faces the task of running a facility that resembles a county hospital in its scope of services - but without the public funding to deliver them. In addition to the hospital, Priselac has managed several clinics under the Cedars-Sinai Health System banner.

Priselac has accomplished his task well enough that U.S. News & World Report ranked Cedars on its recent list of top hospitals in the West.

Despite the demands of running such a large operation, Priselac chairs the California Healthcare Association and is a founding member of the California Health Care Foundation.

Mary Rainwater Executive Director Los Angeles Free Clinic

Often lost in the debate over restructuring the nation's health system is the fact that millions of people have no access to it at all - no matter what shape it eventually takes.

Mary Rainwater has spent seven years at L.A. Free Clinic, the last five at the helm, trying to compensate for that tear in the social safety net. As the clinic enters its fourth decade, she's steering the $4-million-a-year organization into new territory through an upcoming alliance with L.A. County to provide health care services for the region's uninsured indigent population.

Prior to her move to the clinic, Rainwater worked for the county in a variety of posts. She was also a founding member of the Community Clinic Association of Los Angeles County and the California Primary Care Association.

Anthony Rodgers CEO L.A. Care Health Plan

Anthony Rodgers' organization is a quasi-public agency responsible for moving 1.2 million Medi-Cal recipients into seven HMOs to contain costs. That may sound simple on the face of it, but Rodgers and L.A. Care have had to face a gantlet of problems, ranging from innumerable delays imposed by the federal government to major snafus arising from the work of a former state subcontractor that bungled HMO enrollment.

Also, many critics believe the money being paid to the HMOs from L.A. Care will not be enough to adequately care for the Merit-Cal population.

Rodgers acknowledged some frustrations in a recent interview with the Business Journal, saying that L.A. Care has been "constrained by the fact that we can't just go out there and do anything we want."

Rodgers has persevered despite the delays and criticism. Rodgers is pushing for a multicultural approach: L.A. Care literature is printed in more than a half-dozen languages and employees are trained to deal with the various ethnicities of Medi-Cal recipients.

Sam J.W. Romeo President and CEO USC University Affiliates IPA Inc.

The structural changes sweeping the physician community - particularly in the ways that doctors organize for group contracting have largely left academic practices untouched.

But Sam Romeo is leading the faculty practice at USC into tomorrow by "helping the medical school and the faculty physicians develop a group practice orientation and get involved in managed care," he said.

That includes hands-on development of initial contracts with outside payers, contract negotiations and coordination of the relationships and administration of the agreements.

The St. Louis University and National University graduate - and 30-year veteran of the health care industry - is also a national leader in accreditation of ambulatory health care providers.

Besides heading up the individual practice association for USC faculty physicians, Romeo is senior associate dean for clinical affairs and a professor of family medicine at the university's School of Medicine.

Herschel Rosenthal California Senator Chairman of Senate Insurance Committee, Member of Senate Health and Human Services Committee

Herschel Rosenthal, D-Van Nuys, is known as an industry watchdog and consumer advocate, and he has authored a passel of legislation recently to regulate HMOs.

"Since HMOs have become for-profit ... they appear to be more concerned about making a profit than providing care," Rosenthal said. "The profit motive, not community health care goals, appears to be driving the industry."

Rosenthal authored one piece of legislation, which was passed into law, that set up a hotline so consumers could register complaints about HMOs with the state. Another of his bills passed into law requires HMOs to inform patients about the hotline.

The senator's pending bills include one that would require HMO officials who make decisions about medical care to be physicians licensed in California. Another would require the state Attorney General's Office to review HMO mergers to ensure they do not hurt competition and consumers.

Bernard Salick Chairman and CEO Bentley Health Care Inc.

The ultimate compliment may have come to Bernard Salick when The New York Times, in a front-page story last year, conceded he had "chutzpah."

Salick's roots may be blue collar - he's a mile-a-minute talker from Manhattan's Lower East Side - but his skills as a health care entrepreneur are blue chip. He formed his own company in the early 1980s, distraught about the dearth of treatments for his 6-year-old daughter's rare form of bone cancer.

Within a decade Salick Health Care, with its chain of dialysis and oncology centers on the premises of major hospitals, became an industry leader in the "carveout" - taking part of a capitated HMO payment for a specific treatment.

As annual revenues approached $150 million, British Pharmaceutical maker Zeneca PLC bought out Salick Health Care in two phases. Zeneca pushed the iconoclastic Salick out nearly as soon as the deal was complete.

Now, Salick is engineering another startup. Bentley Health Care will focus on "catastrophic care," which involves treating chronic illnesses such as cancer and AIDS.

Leonard Schaeffer Chairman and CEO Wellpoint Health Networks Inc.

As head of Wellpoint Health Networks Inc., Leonard Schaeffer believes continual change is essential for the survival of the massive company.

In his first significant step after joining what was then Blue Cross in 1986, Schaeffer moved the company from being an insurer that simply indemnified members for their medical costs to a plan that provided various stages of managed care.

Then, from 1993 to 1996, Schaeffer orchestrated Blue Cross' transformation from a nonprofit to a for-profit company, taking on the name of Wellpoint.

Finally, in 1996, Schaeffer oversaw the acquisition of two major health plans, Massachusetts Mutual Life Insurance Co. and John Hancock Mutual Life Insurance Co. With these acquisitions, Schaeffer turned a company that formerly had done business solely in California into one with a national presence.

All these changes follow Schaeffer's basic philosophy: "If companies don't continue to change, they'll become extinct."

And that philosophy has served Schaeffer well so far. The company is extremely profitable, no small feat in the tumultuous health care market.

Jacque Sokolov CEO

Advanced Health Plans Inc. and AHP Development Corp.

Ten years ago, Jacque Sokolov practically invented employer-directed managed care as vice president and medical director at Southern California Edison Co.

At Edison, Sokolov developed HealthFlex - a program that integrated the company's self-insured medical plans with an in-house claims payment system, a preferred provider network and a web of primary care clinics.

Not surprisingly, Sokolov's five-year tenure as head of HealthFlex - and the $100 million the program saved the giant utility during that period - made him a national name in health care, and helped launch his worldwide consulting business.

More recently, the USC graduate formed West Hollywood-based Advanced Health Plans to "develop, finance and implement advanced, integrated health systems." Clients include physician organizations, hospital systems, insurance companies, managed care plans and vendors in 100 markets in 40 states, plus three foreign countries.

Bud Volberding President CIGNA HealthCare of California

Bud Volberding is newly arrived at CIGNA from his post as chairman, chief executive and president of United Healthcare of California, where he ran managed care operations in Southern California - and grew that business by 50 percent in 1996 over the previous year.

He now heads CIGNA's operations in three of the biggest states for managed care in the nation. Besides heading the Southern California plan, he is also CIGNA's senior vice president of West Coast Operations, meaning that he oversees plans throughout the Golden State and in Washington and Oregon.

Before his stint at United, Volberding served as Southern California CEO for MetraHealth, where he managed the integration of MetLife and The Travelers' managed care operations after the merger of the two insurance giants.

When he's not marshaling forces at one of the highest-profile names in managed care, Volberding spends time on his association affiliations, including the American Association of Health Plans and the National IPA Coalition, which until recently was called IPA Association of California. He's also a founding member of the California HMO Information Systems Group.

Michael Weinper Founder and CEO Physical Therapy Provider Network

In 1985, Michael Weinper and his partner, Fred Rothenberg, started both a company and a revolution. The two looked at the burgeoning managed care industry and realized that ancillary services providers who wanted a piece of the action needed to walk the walk - just like the primary care physicians and specialists.

Physical Therapy Provider Network became one of the first - and arguably the most aggressive - organizer of non-physician providers into bargaining entities with the geographic coverage and market clout to negotiate profitable contracts with managed care payers.

The company Weinper formed a decade ago now represents more than 900 provider offices - including physical therapists, speech-language pathologists and occupational therapists - and maintains more than 200 contracts with HMOs, PPOs, insurers, workers' compensation providers and self-insured employers, covering 26 million people and generating about $50 million a year in claims.

In addition to a Woodland Hills-based network, the 30-year health care industry veteran also runs his own practice, Progressive Physical Therapy, in Tarzana. And he's active in the American Physical Therapy Association.

Michael Weinstein President AIDS Healthcare Foundation of Los Angeles

Michael Weinstein is co-founder and chief executive of the largest AIDS service provider in the United States, the top executive of an organization with a $30.5 million budget and a payroll of nearly 400 workers.

Under Weinstein's guidance, the AIDS Healthcare Foundation has grown to its current prominence from its beginning as a group of friends fighting for better care for AIDS victims. The foundation now operates five outpatient care centers and three residential hospices throughout Los Angeles, as well as Positive Healthcare, the first managed care program for people living with AIDS.

Besides his role at the foundation, Weinstein serves as an executive board member of the AIDS Action Council, the nation's largest AIDS advocacy organization, with more than 100 member organizations.

Carl Weissburg Partner Foley Lardner Weissburg & Aronson

In a region overflowing with mega-law firms, the house that Carl Weissburg built - then merged with Milwaukee-based Foley & Lardner - attracts some of the biggest names in health care.

Weissburg says the firm's 60 or so health care experts represent "really significant providers, systems and hospitals, including public and university- and religion-affiliated institutions."

He heads the Century City-based firm's Health Care Business Practice Group, and specializes in mergers and acquisitions, as well as formation and operation of managed care plans and integrated delivery systems. In addition, he is an expert on negotiating prepaid Medi-Cal and Medicare contracts.

The UCLA graduate is also legal counsel for the United Hospital Association and the Federation of American Health Systems.

Since starting his own firm in the early 1970s, Weissburg has stayed on top in the health care field by "staying on the very cutting edge of health law, giving us the opportunity to anticipate changes in the law," he said.

James T. Yoshioka President, MedCenters Division UniHealth

If anyone qualifies for the title of "financial surgeon for hospitals," it could well be James T. Yoshioka.

An accountant by training, Yoshioka has engineered some of the most dramatic financial turnarounds at L.A.-area hospitals.

Childrens Hospital of Los Angeles, for example, was on the verge of bankruptcy when Yoshioka joined the hospital as chief financial officer in 1981. In less than a year, he had stopped the flow of red ink and was credited with $15 million in cost savings. That earned him a promotion to president and chief executive.

As Yoshioka sees it, trimming the financial fat from hospitals doesn't necessarily mean cutting services. In fact, he insists a hospital "can maintain a strong business sense without compromising its commitment to community service."

In his current role as president of UniHealth's MedCenters Division, an operator of non-profit hospitals, Yoshioka must implement that policy on a large scale. The division is one of Southern California's largest non-profit hospital systems, with more than 2,000 beds.

Yoshioka has refocused the division from eight independent hospitals into a single operating company that he says is better positioned to function effectively in today's marketplace.