Merging Organizations
Mergers and acquisitions in the health care environment are growing on a daily basis. According to Ellis. J. and Razovi A. it has increased by 11% since 2010. There is so much impetus to this related to the process of bringing competitive organizations to join hands and work together to reduce costs, improve quality outcomes. One of the most important factors is that there now is a rarity of an independent family practice physician, because the cost of maintaining is beyond the ability to remain monetarily successful. Change is a difficult thing, so matter what the issue is, however, merging organizations has increased stress, to all personnel; fear of the future, and uncertainty of job stability can make this a significant risk for taking a toll on the health and wellbeing of all employees. Most organizations sit down at the table in order to create a better, more improved financially stable business that can withstand the future of health care today. Smaller operations are not able to compete, related to the lack of necessary services, financial backing, and ability to purchase higher costing equipment to improve their ability to be competitive, and marketing prospects appropriate in this highly competitive environment.

Another type of merger, that is on the rise today, is an accountable care organization (ACO) which is a group of health care organizations and providers, characterized by a payment and care delivery model, which seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients. A group of coordinated health care providers forms an ACO, which then provides care to a group of patients. The ACO may use a range of payment models (capitation, fee-for-service with asymmetric or symmetric shared savings, etc.). The ACO is accountable to the patients and the third-party payer for the quality, appropriateness and efficiency of the health care provided. According to the Centers for Medicare and Medicaid Services (CMS), an ACO is "an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. It does not have the same effect as a merger or an acquisition, but change will still take place, staff may see policies and procedures change, that are uncomfortable unless appropriate steps are put into place., however it is rare in this environment that job layoffs occur, as each entity keeps its employees, as there is no duplication from the individual components of the ACO. The main organization may change policies and procedures, billing methodology etc. but the basis of each element remains the same.

Communication is the key
Communication is the uttermost key to successful integration of both organizations and it must begin at the top with clear, simple, accurate information coming downward to rationalize the “why “behind the plan. For this merger, one of the important aspects is the introduction of new services not available, and the increase in how each one of the new departments will enhance that already in service, and bring more patients, etc. to the organization. Communication should begin before the deal closes, to share as much as able, large and small, by providing meaningful reassurances to staff at all levels. Communication should be constant, without fail, even when there does not appear to be much to say, the fact that it is taking place helps staff feel more comfortable about the up-coming merger. The effectiveness of frequent communication can be energizing, if stated, again in simple, understandable and factual, two-way, relevant information rumors can be dispelled as much as possible. When staff do not understand how they fit into a new environment, change is resisted to the fullest extent, which is why, again, then communication issue that