ACMC does well in quality indicators. In the local market, where the big competitors are Kaiser and Sutter, "our results are equal in many areas to Kaiser. But the wait to see specialist [at ACMC] is a lot longer and because of this, if you have a choice as a patient, I will lose. If [safety nets] can't deliver on the access side, we'll see volumes decrease."
Many of ACMC's patients don't enjoy their experience because of those time lags. "That will be significant for safety nets," Lassiter says. "For others who might be interested in the expanded market, if you can't deliver on access, you will lose."
He doesn't want that to happen, which is why he's staking so much of ACMC's long-term strategy on acquisitions of facilities that don't have the size or scale to survive healthcare reform. If integrated into the local safety net, Lassiter believes they could offer more varied and quicker access points than ACMC is currently able to provide.
He calls the deal with San Leandro and Sutter, which will leave ACMC as the owner, a "hybrid" model of delivery. The lines are going to blur between safety nets and other hospitals more and more, he argues. "Communities will be stronger if they move to hybrid models. There will be a number of communities where safety nets will not be stable without a partnership."
For that matter, some traditional nonprofit standalones will not be stable without a deep-pocketed partner, whether that partner is a safety net hospital or not.
"In our area, when you [take out] Kaiser and Sutter, what's left are standalones that don't have the financial wherewithal to exist on their own," Lassiter says. Meanwhile, "we need broader geographic coverage and we both need larger scale and presence."