Date of Conferral

3-30-2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Laurie Latvis

Abstract

Acute care hospitals continue to experience financial strain as the healthcare system transitions from fee for service to value-based reimbursement (VBR) models. The purpose of this integrative review was to identify evidence-based financial, clinical, and operational strategies that support hospital adaptation to value-based models while maintaining financial stability and high-quality care. The guiding question focused on determining which strategies reduce financial pressures and improve value-based performance in acute care hospitals. Guided by resource-based theory, this integrative review included 25 empirical and nonempirical studies published between 2019 and 2025 that examined U.S. acute care hospitals. Data were synthesized through a thematic analysis that revealed three major themes: (a) optimize financial structures to support value-based care, (b) redesign clinical care for cost-effective outcomes, and (c) strengthen workforce and organizational capacity to sustain value-based transformation. The themes were made up of nine subthemes. Recommendations are to implement targeted financial strategies through VBR participation, cost-containment, and performance-based incentives, redesign clinical strategies to standardize pathways and protocol and enhance care coordination and improve operational strategies with electronic health record investments and workforce competencies and accountability. Applying these strategies may help hospital administrators improve organizational sustainability, elevate care quality, and promote positive social change by advancing equitable and efficient healthcare delivery, particularly for underserved and resource-limited populations.

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