How Thrivence Led the Nation’s Largest Rural Healthcare Transition in 2025

In rural healthcare, transitions are never just transactions.

They determine whether hospitals remain open, whether care continues uninterrupted, and whether communities retain access to critical services. When financial distress, ownership change, or bankruptcy intersect with already-thin margins, the margin for error disappears.

That was the reality facing one of the most complex rural healthcare transitions in 2025. Multiple hospitals. Dozens of buyers. Hundreds of vendors. A workforce in flux. And no room for disruption.

Thrivence was trusted to lead it.

The Stakes: Continuity, Cost, and Confidence

Following the acquisition of two hospitals, a large healthcare system inherited an extraordinarily complex set of Transition Services Agreements (TSAs) spanning IT and Revenue Cycle operations across nine buyers. The scale was unprecedented:

• TSA costs were escalating rapidly due to delayed exits
• Nearly 650 employees transitioned into the organization amid uncertainty and morale risk
• Over 300 vendor contracts required review, renegotiation, or termination under bankruptcy court oversight
• Buyer coordination spanned 26 hospitals, each with distinct expectations, timelines, and dependencies

What made this transition different was not just its size. It was the risk concentration. Any misstep could result in service disruption, revenue leakage, workforce attrition, or regulatory exposure.

This was not a situation that called for advisory support alone. It required hands-on leadership, disciplined execution, and trust at the highest levels.

Why Thrivence Was Chosen

Thrivence was engaged to serve as the central leadership and program management office for the entire transition. The mandate was clear: protect patient care, stabilize operations, and exit TSAs without incurring unnecessary cost or risk.

Our role extended well beyond coordination. Thrivence became the connective tissue across Revenue Cycle, IT, Operations, Legal, HR, buyers, and vendors, bringing structure to an environment defined by uncertainty.

What Execution Looked Like in Practice

Thrivence established a formal TSA governance and execution model designed to operate at scale:

• A centralized structure to manage TSA performance, extensions, and buyer negotiations across more than 300 applications
• A disciplined vendor contracting effort, including the review of approximately 300 contracts and the repapering of more than 150
• A vendor prioritization and scoring system to protect mission-critical services
• Vendor town halls with more than 100 participants to align reimbursement processes through the bankruptcy fund
• Transparent reporting through a purpose-built vendor dashboard used by executive leadership and the board

At the same time, Thrivence partnered closely with HR and operational leaders to support workforce integration. Clear communication, regular town halls, and consistent messaging were critical to maintaining trust among employees navigating a turbulent transition.

The Results: Measurable, Verifiable, and Durable

The outcomes of the engagement were significant, measurable, and sustained:

• More than $35 million in cost avoidance and revenue protection through negotiated TSA extensions, funding future initiatives such as IT modernization and EHR implementation
• Zero service disruption across mission-critical IT and Revenue Cycle functions, even as TSA exits progressed
• 96 percent vendor contracting completion, ensuring operational continuity and risk reduction
• $350,000 in immediate cost reductions and more than $50,000 per month in recurring telecom cost avoidance
• Over 90 percent retention among 650 transitioned employees, a notable achievement in large-scale healthcare integrations
• A scalable managed services foundation, positioning the organization to support other community hospitals in the future

Perhaps most importantly, the transition preserved confidence. Confidence among buyers. Confidence among employees. Confidence among leadership and the board that the organization could navigate extraordinary complexity without compromising care.

The Transition by the Numbers

• $35M+ in cost avoidance and revenue protection
  Achieved through disciplined TSA governance, negotiated extensions, and tightly managed wind-down planning.
• 26 hospitals supported across multiple buyers
  Coordinated TSA exits and service continuity across a complex, multi-buyer environment with no central playbook.
• 9 buyers aligned under a single operating structure
  Established clarity, cadence, and accountability where fragmented expectations previously created risk.
• 300+ vendor contracts reviewed
  Including renegotiation, termination, or repapering under bankruptcy court oversight.
• 150+ contracts repapered
  Prioritized based on mission-critical impact to IT and Revenue Cycle operations.
• 96% vendor contracting completion
  Ensuring uninterrupted delivery of critical services throughout the transition.
• $350K in immediate cost reductions identified
  Plus $50K+ per month in recurring telecom cost avoidance.
• 650 employees transitioned
  Supported through clear communication, structured change management, and leadership alignment.
• 90%+ workforce retention
  Significantly outperforming industry norms during large-scale healthcare integrations.
• Zero disruption to patient-facing IT and Revenue Cycle services
  Preserving continuity of care during one of the most complex rural healthcare transitions in recent history.

What This Means for Healthcare Leaders

Rural healthcare leaders face a growing wave of transitions driven by financial pressure, consolidation, and regulatory change. The question is no longer whether transitions will occur, but whether they will be executed with discipline, empathy, and foresight.

This engagement demonstrated what is possible when experienced operators lead from the center, align stakeholders, and treat transitions as mission-critical moments rather than administrative exercises.

Thrivence did not simply manage a transition. We protected access to care, safeguarded financial stability, and helped build a platform for future growth.

A Partner for High-Stakes Healthcare Transitions

Healthcare leaders do not need more advisors. They need partners who can step into complexity, lead decisively, and deliver outcomes that matter.

That is why Thrivence was trusted to lead the largest rural healthcare transition of 2025. And it is why organizations facing their own defining moments turn to us when the stakes are highest.