Kaiser doesn't have a "bottom line" to support. North and South Kaiser are two completely different orgs, but they both use the same EHR technology and can move records between them with no real friction.
Kaiser exists to maximize healthcare for reasonable costs across a wide range of people, and they do so by keeping general health high, but at the expense of specialty. In a city like SF, that means Kaiser will send you to UCSF for a transplant and pay a significant fraction. In Solano and Yolo/Sacramento there are far fewer specialists and even then I'd expect you to be referred to UCSF (when I worked there, there were constantly people visiting from all over the state for transplants).