Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Marilyn Simon


In 2017, healthcare system mergers in the United States set a record with 115 deals made and 11 involved sellers with net revenue of at least $1 billion; however, it is common for hospital business office productivity to suffer during a merger. Grounded in the theory of business process re-engineering, the purpose of this qualitative single case study was to explore strategies hospital leaders in the southeastern United States used to maintain business office productivity as they completed a merger. A review of documentation from archival records supplemented in-depth interviews with 7 purposively selected hospital leaders. Yin’s 5-step analysis guided the coding process of participants’ responses, and member checking was used to validate the transcribed data. The major themes of the study revealed that strategies for hospital leadership maintaining business office productivity require (a) presenting unified and consistent messaging, (b) openly sharing outsourcing advantages, (c) making a concerted effort to alleviate the fear of the unknown, and (d) proactively addressing potential challenges. A recommendation for hospital leaders is to preemptively confront the potential obstacles and elucidate opportunities presented by the merger. The implications for positive social change include the potential for hospital leadership to increase productivity, enhance patient quality of care, and improve surrounding communities’ economic stability.