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Success Factors in Merging Teaching Hospitals

Thier, Samuel O. MD; Kelley, William N. MD; Pardes, Herbert MD; Knight, Amy Wimpey MHA; Wietecha, Mark MS, MBA

doi: 10.1097/ACM.0000000000000094

Merger has served as a major strategy for the leaders of academic medical centers (i.e., teaching hospitals) who are pursuing health system development for their institutions. Applying hindsight to their personal experience, the authors explore common themes in several mergers that have survived the test of time. Although many elements influence merger outcomes, experience suggests several of unique importance. These include effective leadership in the areas of creating trust, managing uncertainty, ensuring medical staff stability, and bridging cultural divides across the organizations. While a quantitative business case should support any merger, the authors’ experiences underscore the importance of successfully assessing and managing organizational and individual dynamics when bringing together major teaching hospitals.

Dr. Thier served as chief executive officer (CEO), Massachusetts General Hospital, and subsequently served as CEO, Partners Healthcare, from 1996 to 2002, Boston, Massachusetts.

Dr. Kelley served as executive vice president, University of Pennsylvania, chief executive officer (CEO), University of Pennsylvania Medical Center, dean, Perelman School of Medicine at the University of Pennsylvania (1989–2000), and subsequently served as CEO, Penn Medicine, University of Pennsylvania Health System (1993–2000), Philadelphia, Pennsylvania.

Dr. Pardes served as vice president for health sciences and dean of the faculty of medicine, College of Physicians and Surgeons, Columbia University, and chief executive officer, New York-Presbyterian Hospital, from 2000 to 2011, New York, New York.

Ms. Knight is senior vice president and chief operating officer, Children’s Hospital Association, Alexandria, Virginia.

Mr. Wietecha is president and chief executive officer, Children’s Hospital Association, Alexandria, Virginia.

Editor’s Note: A commentary by R. Azziz appears on pages 208–211.

Funding/Support: Reported as not applicable.

Other disclosures: Samuel Thier participated directly in the Partners merger involving Massachusetts General Hospital and Brigham & Woman’s Hospital, and he served as an external reviewer for the merger between the Stanford and University of California, San Francisco medical centers. William Kelley participated directly in the merger involving the University of Pennsylvania Health System and the Presbyterian Hospital, and in the merger involving the University of Pennsylvania Health System and the Pennsylvania Hospital. Herbert Pardes participated directly in the New York-Presbyterian Hospital merger involving the former New York Hospital and the former Presbyterian Hospital. Mark Wietecha participated directly in the Kurt Salmon merger involving the former Kurt Salmon Associates and Ineum Consulting, and in the transaction involving the sale of Kurt Salmon Associate’s common stockholding to MCG PLC. Mr. Wietecha was involved as an advisor in the following merger or postmerger integrations referenced in this article: CareGroup merger involving the former Beth Israel Medical Center and the former New England Deaconess Medical Center, Indiana Health (formerly Clarian) merger involving the former Indiana University Medical Center and the former Methodist Hospital, Mount Sinai NYU merger involving the Mount Sinai Medical Center and New York University Medical Center, and the University of Pennsylvania Health System merger involving the Pennsylvania Hospital. Amy Wimpey Knight served as an advisor in the postmerger integration of the Mount Sinai NYU merger.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Mr. Wietecha, Children’s Hospital Association, 401 Wythe St., Alexandria, VA 22314; telephone: (703) 797-6012; e-mail:

© 2014 by the Association of American Medical Colleges