When two strong health systems come together, the process is rarely simple, but it can open the door to meaningful impact. That was the case for Froedtert Health and ThedaCare, two community-driven organizations in Wisconsin. In 2023, they saw a strategic opportunity for aligned growth, improving their capabilities for achieving health in the communities they serve by working as one. Their journey reflects broader trends in healthcare consolidation, driven by the need for scale, access, and innovation.
“The decision to combine was grounded in a shared commitment to expanding access, delivering more comprehensive care, and building a stronger foundation for the future,” said Dr. Imran Andrabi, president and CEO of the combined Froedtert ThedaCare Health. Each health system brought unique strengths to the table while sharing similarities: both systems were financially sound, clinically strong, and most importantly, aligned in their missions. The result was the formation of a leading Wisconsin-based health system with more than 22,000 employees and 3,400 providers offering services in 19 hospitals and more than 360 outpatient locations.
Forvis Mazars has been privileged to support Froedtert ThedaCare Health at key points in its journey, including a joint venture and quaternary partnership prior to the integration, development of a letter of intent to combine, and strategic planning after the two systems combined. In this article, we share lessons learned and insights for organizations on a similar journey.
Pursuing a Strategic Combination
The decision to combine Froedtert Health and ThedaCare was supported by strong leadership across both organizations. Two key players were Scott Hawig, then chief financial and administrative officer, and David Olson, then chief business development officer, who recently sat down with Forvis Mazars for a conversation about their integration journey.
Together, Hawig and Olson brought deep experience in navigating the complexities of health system strategy and operations. Their understanding of the evolving healthcare landscape helped shape early conversations, contributing to a thoughtful, goal-oriented integration. Importantly, this work was part of a broader, collaborative effort that included dedicated leadership across both organizations to help ensure the process was inclusive, intentional, and mission-aligned.
While both Froedtert Health and ThedaCare were performing well independently, there was a growing awareness that the local and national healthcare landscapes were rapidly changing. Patient expectations were increasing, care delivery models were shifting, and digital health innovation was accelerating. Both leaders shared that, as they watched health systems across the country begin to consolidate, it became increasingly evident that the time was right for Froedtert Health and ThedaCare to consider taking a similar step.
However, the decision to combine was not reactive—it was a proactive move grounded in shared values and a long-standing vision for regional impact. Both organizations understood that if a combination were to happen, it needed to be on their own terms and driven intentionally. This was a chance to play a part in shaping the future of care in Wisconsin, and to create a more connected regional network—one that could improve care coordination, expand access, and invest more boldly in digital care and innovation. Their goal was to deliver a seamless experience for patients across the continuum of care, while remaining grounded in the community values that defined both systems.
Governance & Culture: Key Success Factors
A key factor in Froedtert ThedaCare Health’s success was the mutual respect between leadership teams. From the beginning, both organizations approached the partnership as equals. This mindset shaped everything from how they made decisions to how they handled communication. The leadership structure was intentionally defined early, helping avoid further confusion and establish clarity about roles and responsibilities. A critical tool that supported early alignment was the significant investment in board and leadership education on the wide range of capabilities across the two systems, including ambulatory, acute, rural, and community care, as well as academic affiliation agreements.
Hawig shared, “With the amount of orientation and training that went in, people are comfortable enough to make votes, have discussions. We have a high-participation governance.” By creating a common understanding around key concepts, leaders were better equipped to collaborate, make decisions, and communicate effectively. This foundation helped accelerate trust building and keep discussions focused on collective goals rather than organizational differences.
Another factor that contributed to a successful combination was that both systems already had strong cultures focused on quality and process improvement. That cultural alignment meant that integration did not require a radical shift in values. Instead, it allowed both systems to build on what already worked, reinforcing shared priorities around patient-centered care, continuous improvement, and accountability. This common ground made it easier to align teams, adopt best practices from each side, and maintain focus on long-term goals without getting stalled by cultural resistance. It also helped foster a sense of mutual respect and partnership across the newly combined system.
Expanding Access & Capabilities
By combining resources, Froedtert ThedaCare Health has been able to expand both access and capabilities. One particular growth area was digital innovation. Pooling resources allowed the system to invest in digital platforms that neither could have pursued at the same scale alone. According to Hawig, “There was a little bit of overlap in digital pursuits, companies we were working with. And then for those that didn’t overlap, it really inspired the team to dig deeper on benefit realization and ability to implement more broadly.”
Bringing together different operational models also proved to be a strength. Between the two systems, leaders had experience managing academic medical centers, community hospitals, and critical access hospitals. That range helped create a unified system that could flex across different care environments while keeping patient outcomes at the center. The integration also added depth to the combined system’s skill sets. Most notably, the integration helped Froedtert ThedaCare Health build a tighter care delivery network that could better support patients across the care continuum in urban, suburban, and rural communities.
One key benefit of combining two health systems is aligning operations and clinical care across a broader network. This creates opportunities to standardize clinical protocols, streamline service lines, and improve patient flow, leading to more consistent, coordinated care. It also enables greater investment in technology, such as unified electronic health records, which can enhance both provider experience and patient access.
Lessons Learned
No integration is without its challenges, and both Hawig and Olson spoke openly about what they would approach differently in hindsight. Olson reflected that the process of identifying the IT strategy for the combined system has taken more time than expected. “The lead time on some of those changes ... it’s years to get to a common EMR (electronic medical record) platform. And yet that’s probably one of the things that will help us integrate care across the entire enterprise the quickest.”
Another significant lesson came from the strategic planning process. Hawig recognized that during the integration, the organization may have tried to tackle too much in its first year, which made it difficult to give each area the dedicated attention it deserved. More recently, Froedtert ThedaCare Health has begun working with Forvis Mazars to create a focused strategic plan built around three system success measures: quality and safety, access, and financial.
Insights for Similar Integration Efforts
For other healthcare organizations considering integration, Froedtert ThedaCare Health’s experience offers practical lessons grounded in both successes and challenges:
- Begin as true partners. Approaching integration as a partnership of equals helped these two health systems foster trust and collaboration from the start.
- Define key roles early. Setting up a clear leadership and governance structure upfront helped reduce uncertainty and allowed the teams to move forward with greater alignment and confidence.
- Prioritize education across stakeholders. Investing in board and stakeholder education helped everyone speak the same language and work toward the same goals.
- Avoid trying to do it all at once. Integration takes time and focus, especially alongside day-to-day demands. A more focused strategic planning process can help organizations identify and achieve key priorities, rather than spreading efforts across too many objectives.
- Build a structured process. Achieving an aspirational vision requires a clear road map and defined framework for integration. Dedicating resources and establishing an internal team focused specifically on integration can help maintain momentum and accountability.
- Balance ambition with clarity. Setting ambitious goals is important, but it is just as essential to make those goals measurable and visible to the entire team. That clarity helps teams stay focused and aligned throughout the process.
How Forvis Mazars Can Help
Froedtert ThedaCare Health’s integration journey demonstrates how shared values, strong leadership, and cultural alignment can create a solid foundation for long-term success. At Forvis Mazars, our healthcare strategy and finance professionals are committed to helping organizations identify and navigate similar aligned growth opportunities. We help clients build the strategic agility necessary to navigate change and stay focused on performance. If your organization has questions about exploring a partnership or strengthening an existing relationship, please reach out to our team.