Russ Foster Russell D. Foster

Principal,
pmpm® Consulting Group Inc.

Mr. Foster has more than 20 years of experience in development and management of health care systems, including expertise in capitation agreements, rate development methodology, and business plan development. Specializing in financial modeling and analysis, he co-founded pmpm® Consulting Group Inc., where he works with clients nationwide in financial modeling and analysis relating to IPA and MSO development and enhancement, capitated reimbursement programs, design and analysis of utilization and cost structures, and all other aspects of managed care systems. He also served as Executive Director for two IPAs and one MSO. Previously, he was Health Plan of America’s Vice President & General Manager, directing all group and provider service activities for HPA’s Northern California region. He also managed all site development for HPA in the Northern region. 

In long prior association with Jurgovan & Blair, Inc., Mr. Foster had primary responsibility for several ground-breaking projects. He developed and implemented a capitated Medicaid program in Kansas City, Missouri. This project resulted in the development of Missouri’s capitation rate methodology, a utilization and cost reporting system, and an annual financial compliance audit program. He managed JBI’s MediCal claims processing centers in Santa Barbara and Monterey, California, developing the first fully automated personal physician accounting system for MediCal providers. As Director of Medical Economics for JBI’s contract with HPA, his department developed HPA’s rate-setting methodology for capitated contracts. He supervised negotiation of the company’s first fully capitated agreements with participating hospitals and physicians, development of the company’s premium rate development methodology, and establishment of their first set of formal underwriting guidelines. 

Mr. Foster served for five years as Chief of the Financial and Management Evaluation Section of the California Department of Health Services Audits and Investigations Division. Here he planned, organized and directed the audits of all capitated MediCal provider organizations. He was responsible for conducting annual examinations of utilization and cost reports. He also developed and negotiated annual capitation rates for the State of California.