Success Story: Big-Town Medicine Meets Small-Town America


The leaders of a small regional health system made a strategic decision that they needed a partner if they were to deal successfully with increasing capital needs, reimbursement cuts and changing patient volumes.

They identified an out-of-town investor-owned health care group that offered the needed combination of clinical, quality and operational resources. It had the ability to acquire and improve their smaller system, which was essential to positioning it for population health management in this new era of healthcare.

While the system’s leadership was confident about the partner and the transaction itself, they had anxiety about its reception among internal and external stakeholders. In an economically challenged community, the system was a leading employer and economic engine for the region. The partnership represented the biggest transaction in the community in a generation, and the conversion from not-for-profit to for-profit status required jumping several regulatory hurdles.

While the carefully constructed partnership was designed to preserve opportunities for employees, physicians and the community, these groups could potentially thwart a successful announcement and completion of the transaction. In addition, what could be expected from the labor union, independent physicians and the neighboring hospital that opposed the deal? And how could others be convinced to see the partnership as a positive change?


Realizing that this situation required a smart political and communications campaign, we focused on specific goals:

  • Rally the troops — employees, physicians and patients — around the system’s vision for the future and build excitement about the new partner;
  • Neutralize the opposition by building an army of supporting voices and making it politically safe to support the partnership; and
  • Complete the transaction without regulatory hiccups and create a significant new foundation as a result of the partnership.

Any smart political campaign needs a campaign team. In this case, the team included leadership from the system and the partner, board representatives, communications experts, attorneys and the broker. With clearly defined roles, we worked with the team to develop and execute a detailed plan that included:

  1. A three-phased campaign. The first phase involved talking with key stakeholders at the system and developing targeted messages and a communications strategy for unveiling the new partner. The second phase centered on announcing the letter of intent, which took place in one day with a carefully planned timeline of events and preceded the following weeks of extensive engagement inside and outside the organization. The final phase focused on clearing regulatory hurdles, helping the system’s internal and external audiences get to know their new partner and preparing the organization for a smooth integration.
  2. A joint approach to communicating about the partnership and answering questions from various audiences. Employees, physicians, the media and the local community were likely to scrutinize the new partnership. The system and the partner made it a priority to present a united front in all engagement with the presence of leadership from both organizations.
  3. A “pressure valve” component that allowed constructive ways for audiences to express concerns and ask questions. Ongoing, deliberate engagement at every level of the organization and the community was imperative to gain advocates—and to allow people to air concerns. In addition to town halls, rounding, one-on-one meetings, calls and memos, a campaign website and newsletter were created to allow for two-way communication with all stakeholders. The partner brought in a team from human resources to meet with employees to explain changes to their benefits. Without these opportunities, the opposition would have been more likely to go to the media to air their grievances.


On the day of the initial announcement, a cascade of carefully orchestrated communications generated relief and excitement. A celebratory mood swept through the system because of its transparency and commitment to keeping jobs. The welcome investment in the hospital was seen as a source of opportunities for employees and the community.

Thanks to a strategic series of meetings, the labor union never challenged the partnership. Media coverage was positive, balanced and fair. The partnership cleared the regulatory requirements, including two successful public hearings. Concerned independent physicians eventually got on board. The transaction closed successfully, and the resulting creation of a new foundation was seen as a stunning development to benefit the local community.

The system’s leadership called the partnership an investment of “big-town medicine in small-town America,” and a strategic campaign approach sent that message reverberating throughout media coverage and other communications. The result was peace of mind about what was to come.


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