Healthcare reform has prompt many healthcare organization’s to change how they operate (Stainton, November 2016). Healthcare organization like RWJBarnabas Health expanded their network by consolidating with other hospital’s to remain competitive in the healthcare industry. With the new policies of healthcare reform, the focus is now on quality not quantity and preventive care for incentives with less hospitalization, which as a result, it changed the whole reimbursement landscape and how RWJBarnabas Health traditionally operated (Stainton, November 2016). As a result of the changes, RWJBarnabas Health, through several mergers, have change their operation by increasing patient volume by creating more outpatient, preventive care settings