Why healthcare M&A success depends on nursing empowerment | Viewpoint

With rising costs, shifting regulations, and pressure to expand revenue streams, it’s no surprise that healthcare leaders are pursuing mergers and acquisitions.

Dr. Bethany Robertson

This process has several layers, and the most obvious are the plethora of high stakes legal and financial tasks needed to bring these agreements to the finish line. The next layer is engaging the workforce around the “why” of the transaction as it relates to organizational mission and then, the “how” follows closely behind.

People are at the heart of an organization and they are interested in how the change will impact them personally. Nurses are the largest workforce and are the engine of patient care; ensuring they are engaged in the process is critical.

How nurses experience changes throughout the M&A process can make all the difference in the success of the merger and ensure there isn't an associated impact on patient outcomes.

Providing open, frequent and honest communication throughout the process ensures trust does not erode or the whole integration could stall. Turnover rises, morale dips, and patient care can take a hit. Research shows that M&A failures spike — sometimes up to 90% — when the human side is overlooked.

And this human element has a clear, measurable cost. Here’s a fact that stuck with me: the 2024 NSI National Health Care Retention & RN Staffing Report found that the national nurse turnover rate hit 18.4%, with each nurse that leaves costing a hospital around $56,300. Even a small 1% shift in turnover can cost or save a typical hospital roughly $262,500 every year. And during mergers, those numbers can climb as uncertainty may spread.

But a shake up in the nursing workforce is more than just a financial hit related to the cost of turnover. More importantly, quality and safety are at risk.

Too often, though, healthcare leaders are so focused on the business portion of the deal, with things like tech integrations and legal reviews that the people making it all work are overlooked.

Building trust and empowering nurses

From my experience, it makes a big difference when nursing leaders are an integral part of the M&A process. And likewise, those leaders need to engage nursing teams as early as they can be brought in.

Culture is established through vision but more importantly, it is solidified by how things are done. Nurses from both sides of the integration need to be part of building the new organization through policies, processes, and practices. Inclusion in this way goes a long way in building the new culture, enhancing trust, morale and ultimately patient care.

Nurses bring so much practical, real-world experience to the table as they are closest to the workflows associated with patient care. It is essential that nursing leaders are central to building the new culture as it is largely predicated on establishing the new infrastructure of care delivery.

For instance, nurses are deeply vested in supporting the best clinical practices and should be empowered to own and manage the policy, procedures and processes associated with direct patient care. They are uniquely positioned to lead changes that make patient care smoother, help teams work better together, and solve those frustrating, everyday problems that can slow down integrations.

Why now is the time to get it right

According to Kaufman Hall, hospital and health system M&A slowed in the first half of the year. There were 13 announced deals in the first six months of the year, down from 31 in the first half of 2024.

This lull is a chance to pause and rethink how we approach mergers. Focusing on culture and engaging your workforce creates systems that are stronger and more resilient than ever.

So, what’s next? Healthcare is at a crossroads with changes in regulations and market pressures pushing more consolidation. Leaders who see M&A as an opportunity to build trust and empower their nursing workforce can have an upper hand. It’s more than paperwork, and nurses are more than employees; they’re vital partners in shaping the future of healthcare.

By investing in culture, honest communication, and empowering your workforce, you can turn M&A from a risky disruption into a real opportunity for innovation and better patient care.

Dr. Bethany Robertson, DNP, CNM, FNAP, is a clinical executive at Wolters Kluwer Health, Learning, Research & Practice