Consolidation is the purchase of different businesses with their unique culture, processes, and policies and there are major changes that need to happen immediately post acquisition.

According to McKenzie’s report, 70 percent of mergers fail.
A large portion of these failures is attributed to the lack of change management. There are 10 principles that the Consolidator Operating Framework includes in our methodology:

  1. Lead with the culture
  2. Start at the top
  3. Involve every layer
  4. Make the rational and emotional case together
  5. Act your way into new thinking
  6. Engage, engage, engage
  7. Lead outside the lines
  8. Leverage formal solutions
  9. Leverage informal solutions
  10. Assess and adapt


Lack of change management strategy at the level of the consolidator is the single and most important risk factor that will determine their ability to improve operational processes in order to execute the margin expansion using Decentralized Levers.


  • M&A Process
  • Culture/People Integration
  • HR Process/Onboarding
  • Core Processes Implementation
  • Strategic Filter
  • Talent Acquisition
  • Pre- and Post-Acquisition Assessments
  • Training
  • Quarterly Goals/Rock Planning
  • Recruiting at the Hospital Level
  • Implementation of VCP Processes
  • Change Management
  • Data-Driven Change Management
  • Data-Driven VCP Initiative Process


Traction is a methodology that helps to create an environment of high accountability centered around similar Core Values. That in itself empowers the front line staff to make their own decisions and see solutions to day to day issues. It plays an important role in preventing these burnout triggers: Lack of control, value conflict, breakdown of the community.


The most common mistake that de-novo and franchise types of consolidation make is underestimating the need for change in their organization. It happens because there is an initial decision that the original infrastructure, services and revenue streams at the new facilities are established and will not change. But considering that the value creation at the hospital level is being defined while the organization is moving through the maturity levels, a need for well orchestrated change with a buy-in at every level becomes evident. Designing change management in the early levels of maturity is of paramount importance for de-novo and franchise businesses.