BUSI 528 Week 8 Group Case Study Analysis Example

Two Hospitals, One Name? A Group Case Analysis of Branding, Trust and Service Lines After a Hospital Merger

Case Summary

Lakeshore County Medical Center, a 300-bed public hospital, acquired St. Brendan Community Hospital, a 120-bed hospital founded by a Christian order in a town 30 miles away, after St. Brendan lost money for four straight years. The combined organization must choose a name for the system and for each campus. A branding consultant has recommended retiring both names in favor of a new system name, Northshore Health, with uniform signage, a single website and one advertising campaign. St. Brendan's physicians, volunteers and longtime patients have objected, and a local newspaper has run letters asking whether the hospital's maternity unit, the only one in its county, will survive. The board has asked our group for a recommendation.

Problem Statement

The system needs a brand strategy that builds recognition for the combined organization while preserving the trust St. Brendan has earned in its town, at a time when patients are wary of mergers and of health care institutions generally. The naming decision cannot be separated from decisions about what services each campus will keep.

Situation Analysis

Berkowitz (2017) describes a brand as the name, symbol and associations that distinguish an organization and the promise it makes to customers, and brand equity as the value those associations carry. St. Brendan's brand equity is local and personal: generations of families were born there, and its religious heritage signals a particular kind of care. Lakeshore's brand is stronger in the county seat and associated with specialty services such as cardiology and trauma care. Berkowitz also stresses that positioning lives in the customer's mind, so a new name does not create a new position on its own; patients will judge Northshore Health by what they experience under it.

The market context makes the decision harder. Perlis et al. (2024) pooled 24 survey waves from April 2020 through January 2024, more than 580,000 responses in all, and watched high trust in doctors and hospitals slide from 71.5% of adults to 40.1%. Lower trust was associated with rural residence, lower income and lower education, which describes much of St. Brendan's service area, and lower trust was linked to lower vaccination rates, which shows that trust affects health behavior and not only marketing results. A rebrand that feels like a takeover risks deepening distrust where it is already highest.

Stakeholders

Four groups will judge the decision. St. Brendan's physicians and nurses carry much of its reputation, and several have said they would consider leaving if the hospital became a satellite of Lakeshore; losing them would damage the brand more than any name. Donors and the founding order care about the hospital's faith heritage, which a generic system name would hide. Patients in St. Brendan's town want to know that care close to home will continue, especially births and emergency care. Employers and insurers in the region care about prices and will watch whether the merger raises them. A brand strategy that satisfies the consultant's preference for simplicity while losing any one of these groups would be a poor trade.

Market Research Before Deciding

Berkowitz (2017) emphasizes that marketing decisions should rest on research with the customers themselves. Before choosing, the system should survey residents in both service areas about their awareness of and feelings toward each name, run small focus groups with St. Brendan patients and staff and test sample signage and advertising for the endorsed and single-brand options. The research is inexpensive compared with the cost of a rebrand that has to be reversed, as some systems have done after community backlash, and it gives the board evidence rather than competing anecdotes from consultants and letter writers.

Alternatives

Option 1: a single system brand. Both campuses become Northshore Health, with campus names added only for directions. This builds one strong brand, simplifies advertising and signals that both campuses share standards. The risks are losing St. Brendan's local equity, alienating its physicians and donors and appearing to erase the hospital's faith heritage.

Option 2: an endorsed brand. The campuses keep their names with the system endorsement: St. Brendan Hospital, part of Northshore Health, and Lakeshore Medical Center, part of Northshore Health. Local identity is preserved, while the system's resources and specialty services become visible to St. Brendan's patients. The risks are higher advertising costs and a slower build of system recognition.

Each option was judged on the same four criteria: protection of local trust, visibility of system services, cost and fit with the merger's purpose. Option 3: separate brands. Each hospital keeps its name and markets independently, with the system largely invisible to patients. This protects local loyalty but forfeits the merger's chief marketing advantage, the ability to show patients that specialty care is connected to their community hospital.

What the Evidence Says About Mergers

Research on mergers suggests that patients have reasons for skepticism. Beaulieu et al. (2020) set 246 hospitals that changed hands from 2009 to 2013 against nearly two thousand that did not. After acquisition, patient-experience scores slipped modestly, comparable to a typical hospital dropping nine percentile points, while death and readmission rates within a month of discharge did not measurably move. Mergers, in other words, have not reliably delivered the quality gains their announcements promise. Henke et al. (2021) studied rural hospitals in 32 states from 2007 to 2018 and found that merged rural hospitals were more likely than independent ones to eliminate maternal and neonatal care and surgical care, while mental health and substance use stays declined or held steady at merged hospitals even as they rose elsewhere. The letters in St. Brendan's local newspaper reflect a real pattern.

Prices are a further concern for employers and insurers in the market. Capps et al. (2018) showed that hospital purchases of medical practices lifted what payers were charged for those doctors' work by an average of 14.1%, much of it through payment rules that let hospital-owned sites bill facility fees. If Northshore Health moves St. Brendan's outpatient clinics under hospital billing, patients may see higher bills for the same visits, and a new brand name could become associated with that change.

Recommendation

Our group recommends Option 2, the endorsed brand, paired with public service commitments. The St. Brendan name should remain on the building, the website and patient materials, with "part of Northshore Health" added. The system should announce, before any signage changes, three commitments for at least five years: maintaining labor and delivery at the St. Brendan campus, keeping outpatient clinic visits billed at office rates rather than adding facility fees and opening a cardiology clinic at St. Brendan staffed by Lakeshore specialists. The group considered recommending the single brand with a promise to revisit the decision later, but concluded that a name once removed is hard to restore, while an endorsed brand can always be simplified once trust is established. The endorsed approach is the reversible choice. These commitments address the specific risks the research identifies and give the endorsement a concrete meaning, since patients in St. Brendan's town will see that the system brought services rather than removed them.

Biblical Integration

Proverbs teaches that a good name is more to be chosen than great riches and that favor is better than silver or gold (English Standard Version Bible, 2001/2016, Proverbs 22:1). St. Brendan's name carries decades of favor earned through care, and that reputation is worth more than the efficiency of a single logo. A name can be kept or retired in a board meeting, but a good name is only earned in exam rooms and delivery rooms over many years. Keeping the name obliges the system to keep faith with what the name has meant to the town.

Implementation and Measures

In the first quarter, the system should hold listening sessions in St. Brendan's town with physicians, staff, clergy and patients, publish the service commitments and introduce the endorsed signage. In the second quarter, it should open the cardiology clinic and launch advertising that features St. Brendan staff alongside system specialists. Communication matters as much as the decision. Staff should hear about the branding plan before the public, from their own leaders, with time for questions. St. Brendan's chaplains and the founding order should help shape how the hospital's heritage is described in system materials, and the system's website should tell St. Brendan's story rather than burying it in a corporate history page. Every announcement about the brand should be paired with news about services, so that the community associates the system's name with something gained. The board should track four measures each quarter: patient-experience scores at both campuses, births at St. Brendan, community trust measured through a short survey and referrals from St. Brendan to system specialists. If trust and patient experience improve after two years, the system can revisit whether a stronger system brand makes sense. If they decline, the board should look first at whether the service commitments were kept, since the research suggests that what patients lose after a merger, not the name on the sign, drives their judgment. The group also recommends a public report on the commitments each year, so that the community can see the promises tracked rather than simply announced.

Conclusion

The merger gives St. Brendan's community access to specialty care it could not sustain alone, but research shows that mergers often bring worse patient experience and lost rural services. A brand strategy that keeps the local name, adds the system's endorsement and backs both with public commitments offers the best chance of building trust rather than spending it.

References

Beaulieu, N. D., Dafny, L. S., Landon, B. E., Dalton, J. B., Kuye, I., & McWilliams, J. M. (2020). Changes in quality of care after hospital mergers and acquisitions. New England Journal of Medicine, 382(1), 51-59. https://doi.org/10.1056/NEJMsa1901383

Berkowitz, E. N. (2017). Essentials of health care marketing (4th ed.). Jones & Bartlett Learning.

Capps, C., Dranove, D., & Ody, C. (2018). The effect of hospital acquisitions of physician practices on prices and spending. Journal of Health Economics, 59, 139-152. https://doi.org/10.1016/j.jhealeco.2018.04.001

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Henke, R. M., Fingar, K. R., Jiang, H. J., Liang, L., & Gibson, T. B. (2021). Access to obstetric, behavioral health, and surgical inpatient services after hospital mergers in rural areas. Health Affairs, 40(10), 1627-1636. https://doi.org/10.1377/hlthaff.2021.00160

Perlis, R. H., Ognyanova, K., Uslu, A., Lunz Trujillo, K., Santillana, M., Druckman, J. N., Baum, M. A., & Lazer, D. (2024). Trust in physicians and hospitals during the COVID-19 pandemic in a 50-state survey of US adults. JAMA Network Open, 7(7), e2424984. https://doi.org/10.1001/jamanetworkopen.2024.24984