Healthcare & Enterprise Transformation

Most transformation plans are solving the wrong problem.

Garske Associates is a boutique advisory practice specializing in the front end of transformation — diagnosis, system design, and activation — for healthcare systems and complex enterprises.

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How we're different

Senior expertise at the front of every engagement.

Most consultants are optimized for the middle of a transformation. We specialize in the beginning: the diagnostic, the architecture, the activation. When the structural design is right, execution teams have something worth building.

You work directly with Geneva Garske on every engagement — no partner handoff, no associate team with occasional senior review.

Diagnostic first

Every engagement begins with a structured diagnostic that identifies root causes, not symptoms — before recommending any course of action.

Architecture, not just advisory

We design the operating models, governance structures, and change systems that make transformation executable.

Measurable from day one

Engagements are structured around defined outcomes and baseline measures established at the outset. If we can't measure it, we don't claim it.

Healthcare and AI fluency

25 years inside the nation's largest integrated health system, plus hands-on enterprise AI program leadership at scale.

Five areas of focused expertise

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Enterprise Transformation & Change Leadership

Strategy, roadmap design, PMO architecture, change management, and cost structure redesign.

AI Strategy & Digital Transformation

Organizational readiness, AI program design, and human-centered integration for enterprises moving from AI curiosity to AI capability.

Operational Excellence & Process Optimization

End-to-end process analysis, workflow automation strategy, and high-reliability operations consulting.

Healthcare Industry Advisory

Health plan, hospital, and workforce strategy grounded in 25 years inside the nation's largest integrated health system.

Fractional Executive & Strategic Advisory

Fractional CTO, strategic advisory retainer, executive coaching, and board advisory on a flexible basis.

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About Geneva Garske

"I spent 25 years inside the most complex health system in the country. I know what breaking looks like from the inside — and how to build the architecture to fix it."

Geneva Garske founded Garske Associates after 25 years at Kaiser Permanente, most recently as Executive Director of Business Optimization & Redesign. She has led programs ranging from a $900M cost structure redesign to the launch of KP's enterprise AI readiness program.

Executive MBA, Pepperdine University · Beta Gamma Sigma honors

Agentic AI Certification, Johns Hopkins University

Kaiser Permanente · 1998–2025

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Ready to get the diagnosis right?

Most engagements start with a focused conversation — no pitch, no proposal. Just a direct look at what's driving the problem and what it would take to fix it.

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