California HMOs, experts in squeezing costs out of the healthcare system by slashing hospital utilization and placing more physicians at risk, are looking for new lands to conquer. Leading the trend are four big HMOs that have been on an expansion binge east of the Sierras in the past several years. Foundation Health Corp., FHP International Corp., PacifiCare Health Systems and Health Systems International have moved aggressively beyond California's borders, adding hundreds of thousands of new enrollees.