A hospital merger or acquisition is often discussed in terms of finances, operations, service lines, and long-term growth. But while leadership teams are working through the complexities of a transaction, employees, physicians, patients, and communities are asking a different set of questions.
What does this mean for me?
What is changing?
What stays the same?
And who can I trust for an answer?
None of those questions wait for a final integration roadmap, and each deserves an answer the organization can stand behind. That is why communication belongs inside a transaction from its first day, rather than arriving at the end as an announcement.
It is also becoming a more frequent test of leadership. Kaufman Hall counted 46 announced hospital and health system transactions in all of 2025 and 40 in the first half of 2026 alone. More leadership teams will meet this moment soon, most of them with the marketing departments they already have.
The communication challenge starts earlier than you think
During a transaction, facts originate in many places at once. Transaction leadership, human resources, clinical operations, legal counsel, IT, and marketing each hold a legitimate part of the picture, and each works diligently on its own part. What no single function is positioned to produce is a coherent account for an employee, a patient, or a local reporter.
The risk is most visible when a statement about future services reaches the public before clinical operations have confirmed it, or when employees learn a material detail from an outside announcement. The remedy is transparency: a shared, fact-based source of truth and a reliable way to correct misinformation once it is in circulation. Juniper Advisory, which advises nonprofit hospitals on partnerships, found that more than 10 percent of hospital transactions announced over a five-year period were later terminated, mostly for process-related reasons, and that communicating strengths and opportunities effectively among the practices helps a transaction succeed.
One transaction. Many conversations.
A single narrative is not the same as a single message. The overarching account should hold steady while each audience receives the level of detail, timing, and channel it needs:
- Employees need leadership briefings and a reliable way to ask questions.
- Physicians and referral partners need direct clinical and referral information from medical leadership.
- Patients and families need plain-language guidance on access to care, appointments, locations, insurance, and medical records.
- Community leaders and media need clarity about what has been decided, what remains under review, and what commitments have actually been made.
- And every audience and key stakeholder needs confidence in the purpose and intention of the merger or acquisition.
The goal isn’t to create more communication. It’s to make sure all of those communications work together to tell a transparent and authentic story.
That requires a shared message framework, clear ownership, coordinated timing, and a process for updating information as decisions evolve.
What an Agency of Record Adds During a Transition
During a transaction, an agency of record can become more than a marketing resource.
Because an established agency understands the organization’s brand, leadership, audiences, service lines, market, communications channels, and community concerns, it can provide continuity while many other things are changing.
It can also mean preparing for the difficult questions before they are asked, which is why M&A communications guidance favors bringing in a communications lead at the earliest stages of a transaction.
An agency holds no authority over employment, clinical care, regulatory filings, or transaction strategy. The hospital decides. The agency of record ensures that every audience hears each decision accurately and in the correct order.
We saw that division of responsibility work at Liberty Hospital. From March 2023 through the close of its strategic partnership in July 2024, Onspire Health Marketing served as communications and public relations lead alongside Juniper Advisory, the hospital’s lead transaction advisor. Our team mapped communications to each milestone and built messaging and materials across its key audiences: patients, the board, hospital leadership, employees and physicians, media, the community, and civic leaders.
Before the public announcement, Onspire prepared leadership for the hardest questions through a leadership Q&A and dedicated media preparation. Community work ran under a single campaign banner, “Here, we grow,” with a campaign microsite and twice-weekly social content, while a multi-event roadshow carried the story to chambers of commerce, economic development organizations, and hospital associations.
The result was not a single announcement. It was a communications framework, built on transparency, that evolved with the transaction.
Announcement day is only the beginning
One of the easiest mistakes in M&A communications is treating the public announcement as the finish line.
In reality, it marks the beginning of another phase.
Between an announcement, a letter of intent, a definitive agreement, closing, and integration, months can pass. Questions change. Decisions become final. New operational details emerge.
After close, the communications environment can become even more complex.
Websites, signage, physician directories, patient communications, recruiting materials, social channels, and online listings may transition on different timelines. If those changes aren’t coordinated, patients and employees can encounter conflicting information long after the transaction is complete.
That’s why continuity matters.
The communications strategy should extend through integration, with clear ownership for updating information, correcting inconsistencies, and communicating progress against commitments.
Communication can’t replace good decisions. But it can make them understandable.
No communications strategy can solve an operational problem or guarantee the success of a hospital merger or acquisition.
What it can do is help people understand what is happening, distinguish confirmed decisions from future plans, surface questions earlier, and keep communications aligned with what the organization is actually doing.
And during a period of significant organizational change, that clarity matters.
Hospital M&A may be negotiated in boardrooms, but it is experienced by people throughout the organization and the community.
The question for leadership is straightforward: Who owns the complete communications experience of this transaction – not just the announcement?
Go deeper: Communicating Through Change
Our latest white paper, Communicating Through Change – The Agency of Record’s Role in Hospital Mergers and Acquisitions, explores how healthcare organizations can build a more coordinated communications approach across transaction planning, announcement, and integration.
It closes with six conditions leadership can confirm before an announcement, revisit at closing, and again at 90 days: ownership, truth and approvals, audience intelligence, operational alignment, listening and correction, and evidence and continuity.
It follows The Full-Service Advantage, the first briefing in the series, which examined why consolidated accountability matters for regional health systems.
About the Author
Julie Amor, MHA, Chief Strategy Officer for Onspire Health Marketing, has 35+ years of experience elevating hospital and healthcare brands. An architect of strategy with a proven record in leading strategic growth initiatives, she spearheads our strategy-first approach for hospital marketing, including our industry-leading rural health division. To discuss how we can partner with you to accelerate intelligent growth for your hospital or healthcare organization, contact Julie at 816-595-6723 or jamor@onspirehm.com.