Wright Lassiter's Audacious Vision for Safety Nets

So Lassiter and the COO educated. They called the process a "margin improvement boot camp," and gathered 90 leaders and directors to lay out the revenue problem.

"We agreed that this is not the new CEO's problem, this is our collective problem, and collectively we will solve it," he says. "Some of you think you don't know enough, so we're going to give you some training over the next few weeks, and beginning in January, you are going to be placed on cross-functional teams, and given a goal for which you'll have 16 weeks to come up with ideas to solve the problem," he says, recalling his words.

The goal was to save $21 million for the year. Every Friday for 16 weeks, the group met for discussions in which reports on progress for cost-saving ideas were tallied. The group debated ideas for cost improvement, including reduced contract expenses, increased revenue, contract evaluation, better processes and practices, and lastly, salary reductions.

"That really helped drive culture change and ownership culture," he says. "Some had ideas for years, but no one ever asked them, or the idea never went anywhere."

By the end of that year, ACMC ended up with a positive margin of $3 million.

By 2008–2009, in the depths of the recession, Lassiter and his team were faced with a similar shortfall, as the sales tax revenue subsidy fell sharply with the economic downturn.

"We lost that tax subsidy by about $20 million over a single year, and needed more belt-tightening," he says. This time he involved the physicians, who wanted in on the process.  That effort yielded $17-$18 million in savings.