Case Study

Engaging communities to create an historic merger of equals

Two competing health systems desired to combine into one 21-hospital, two-state system to secure a stronger future, eliminate extensive duplication and tackle severe regional health problems. The systems faced interest and concerns from stakeholders and a long, untried road of state-immunity regulatory approvals.

To build support for the merger, we helped them launch a full-scale, unified campaign in their local communities and at the state regulatory approval level.

The Solution

With internal and external support being imperative, we immediately formed – and managed over the three-year effort – a joint campaign team of government relations, community relations, communications, legal and HR leaders from the organizations.

After launching the proposed partnership at an energy-filled press conference, our robust, themed engagement campaign unfolded. It featured a dedicated website, newsletters, ads, regular media interviews, roadshow presentations, internal town halls at the hospitals, patient communications and more. We also formed five community health work groups to shape the combined system’s vision and priorities for the years to come.

Since the government approval process required local listening sessions, we prepared advocates from the local businesses and communities, physicians and employees with key messages to share. This advance engagement resulted in overwhelmingly positive turnout and public support at the sessions. The team navigated more than 50 public meetings and official hearings with 150+ speakers.

The Results

The process to finalize the merger ultimately took years to complete due to the unique regulatory approval process. Throughout this process, the communications campaign was sustained and community support for the merger continued to be overwhelmingly positive.

Ultimately, the merger was approved by the two states’ regulatory bodies
and the new, combined health system was formed.


engaging communities to create an historic merger of equals

The Takeaway

Two like-size not-for-profit competitors desired to merge into a single 21-hospital, two-state system. We developed and executed a sustained communications campaign that engaged the entire community in the partnership, resulting in a successful deal close. 


employees and physicians


public hearings and community meetings


by two states’ attorneys general and health departments