Financial Management Innovation in Hospital Groups: An Empirical Study of Ophthalmology Specialty Care Under Consolidation

Objective: This study examines financial management innovation in a provincial public ophthalmology hospital group in China, focusing on associations among consolidation, shared services, digital transformation, financial performance, and operational efficiency. Methods: We used a mixed-methods single-case design. The quantitative analysis used a campus-month panel from January 2020 to December 2024 (2 campuses x 60 months; N=120 campus-month observations), with descriptive statistics, correlation analysis, and campus fixed-effects pre-post association models with clustered standard errors. Semi-structured interviews with 28 managers and key staff were audio-recorded, transcribed, and thematically coded. Results: Consolidation and digital transformation were associated with higher operating margins and improved process performance, but estimates should be interpreted as observational associations. In adjusted models, the post-consolidation period was associated with 2.8– 3.4 percentage points higher operating margins. Centralized procurement was associated with 18% lower average supply cost in participating categories, and RPA-supported claims processing was associated with a 35% shorter processing cycle and 94% accuracy. The absence of a financial shared service center remained associated with inefficiencies, including an average accounts payable cycle of 45 days. Conclusion: In this single-case observational study, hospital group consolidation was associated with higher operating margins, especially when paired with selective digital transformation. The findings are hypothesis-generating and suggest that integration benefits may depend on shared service implementation and interoperable digital platforms.