Mergers and acquisitions (M&A) have become a defining feature of modern healthcare strategy. Health systems are consolidating at an unprecedented pace—seeking economies of scale, expanded market share, and stronger negotiating power with payers.
But behind the boardroom wins lies a more operational story, one that doesn’t make the headlines: the breakdown of care continuity, perioperative misalignment, and a quiet surge in cost-driving metrics like length of stay (LOS), denials, and surgical delays.
These aren’t just growing pains. They’re avoidable setbacks with high stakes—and they’re happening in the ORs and recovery rooms of newly merged hospitals across the country.
When Integration Lags, the OR Pays the Price
Too often, surgical services become the fault line where pre-merger strategies and post-merger realities collide. Each hospital brings its own protocols, documentation standards, EHR builds, and clinical cultures. Without tight integration, this complexity creates friction at every step of the surgical journey:
- Pre-op: Incomplete workups and duplicative testing due to non-unified order sets
- Intra-op: OR delays from mismatched equipment preferences and scheduling conflicts
- Post-op: Conflicting discharge criteria and LOS benchmarks
This fragmentation drives up LOS, exposes hospitals to more readmission risk, and complicates bundled payment models where cost and quality must be tightly managed.
Denials Surge in Disconnected Systems
One of the most overlooked effects of M&A? A spike in preventable denials.
When surgical documentation, charge capture, and coding workflows aren’t synchronized across facilities, errors and inconsistencies mount. Claims get rejected. Revenue slips through the cracks. And appeals clog up staff capacity.
- Missing surgical modifiers due to EHR mapping errors
- Conflicting clinical documentation between merged providers
- Authorization lapses tied to inconsistent pre-op processes
The result: cash flow disruption, provider frustration, and a drag on the revenue cycle just when merged systems are under pressure to prove their financial thesis.
MGA’s Take: Where M&A Strategy Meets OR Reality
At Modality Global Advisors, we’ve seen what happens when surgical integration is an afterthought. We’ve also helped health systems turn it into a competitive advantage.
Our perioperative consultants work inside the M&A lifecycle—not after the ink is dry, but from the early stages of due diligence to day-one readiness and long-term optimization.
Here’s how we help systems avoid hidden costs:
Pre-Merger Due Diligence
- Assess alignment of surgical protocols, care pathways, and quality benchmarks
- Evaluate technology interoperability, especially EHR surgical modules
- Quantify variation in LOS, surgical throughput, and complication rates
Integration Playbooks
- Standardize order sets, checklists, and intra-op workflows across entities
- Design unified staffing, credentialing, and scheduling models
- Embed best practices from both legacy systems to drive buy-in
Denial Prevention & Documentation Alignment
- Audit surgical documentation, billing, and coding workflows
- Train providers on merged standards, including risk adjustment and mod usage
- Implement pre-bill review tools and real-time charge capture audits
LOS Optimization
- Align post-op recovery pathways and discharge targets across all facilities
- Deploy predictive tools for early discharge readiness
- Reduce unwarranted variation in ICU step-downs and floor transitions
Bottom Line
M&A is not just a financial transaction. It’s a clinical integration challenge—especially in surgery, where small inefficiencies multiply quickly. If surgical misalignment is left unchecked, hospitals risk longer LOS, lower throughput, and lost reimbursement. But with the right plan, surgical services can be a proving ground for synergy, savings, and scalable value.
Let’s Talk Surgical Integration
If you’re planning a merger, navigating one, or recovering from one—Modality Global Advisors is your partner for perioperative alignment, revenue protection, and operational success.
Build your future-ready OR strategy today.