Health system mergers and acquisitions (M&As) have increased exponentially in recent years as a result of the Affordable Care Act (Brown, Werling, Walker, Burgdorfer & Shields, 2012). M&As are consummated as a way to control for interdependencies within the market, control costs and leverage debt, and negotiate better rates among health insurers (Bolman & Deal, 2013; Cooper & Finkelstein, 2010; Mirc, 2013). Regardless of the impetus for a merger, the largest predictor of the success or failure of a M&A lies within the organizational culture (Brown, et al., 2012; Cooper & Finkelstein, 2010; Kastor, 2010; Ovseiko, Melham, Fowler & Buchan, 2015). The purpose of this research was to assess the organizational culture of two competing health organizations prior to a planned merger and understand whether there were significant differences in pre-merger culture compared to a post-merger preferred organizational culture using the Competing Values Framework (CVF). The population included all employees of both health systems with the survey respondent sample stratified by the following employee types: (Tier 1), entry-level employee; (Tier 2), supervisory level, and, (Tier 3), executive level. Statistical procedures included independent t tests, one-way and two-way analyses of variance. Findings indicated a statistically significant difference existed between the current cultures of the health systems prior to the merger; however, both systems sets of employees preferred a post-merger organizational culture that was not statistically different from each other. Further, there were significant differences in the cultural perceptions of Tier 1 employees and Tier 2 employees and no significant differences between Tier 3 employee perceptions of culture as compared to Tier 1 or Tier 2.

With the increase in health system Mergers and Acquisitions (MandA’s) since the Affordable Care Act [Brown TC, Werling KA, Walker BC, et al. Current trends in hospital mergers and acquisitions. Healthc Financ Manage. March, 2012], health systems must carefully weigh and measure the current organizational culture prior to the consummation of the merger, seeking to understand differentiation within and between the merging organizations, and requires that the organization be analyzed by employee levels or tiers. This study seeks to understand the organizational culture of two merging partners before the merger is consummated, identifying levels of differentiation among employee tiers. Cultural domination from an acquiring organization is also considered. The cultures are analyzed utilizing the Competing Values Framework (CVF). The population included all employees of both health systems with the survey respondent sample stratified by the following employee types: (Tier 1), entry-level employee; (Tier 2), supervisory level, and, (Tier 3), executive level. Statistical procedures included independent t tests and indicated a statistically significant difference between the current cultures of the health systems prior to the merger with significant differences in the cultural perceptions of Tier 1 employees and Tier 2 employees.