Most healthcare mergers promise operational efficiencies. Few deliver.

Why? Because while leadership focuses on real estate, personnel, and procurement synergies, they miss one of the most powerful and underutilized cost-saving opportunities: centralized Identity and Access Management (IAM) and Active Directory (AD) consolidation.

The truth is, every disconnected domain, every duplicated access system, and every fragmented security policy adds operational drag and inflates IT spend. In an industry already operating on razor-thin margins, this is a quiet budget killer.

IAM and AD are not just IT concerns. They are financial levers—if designed and executed strategically. For US healthcare systems undergoing M&A, these functions can unlock measurable savings, mitigate risk, and create scalable infrastructure for future growth.

Let’s look at five key ways centralized IAM and AD consolidation drive cost savings in post-merger healthcare organizations.

1. Eliminating Redundant Licensing and Infrastructure

Mergers often result in duplicate software licenses, authentication tools, and identity platforms. Each entity may be running its own AD forest, separate MFA solutions, and overlapping security software.

According to a report by Forrester, 30 to 40 percent of IT costs post-merger are spent maintaining redundant systems simply because no consolidation plan is in place (Forrester Research, 2023).
Maintaining two (or more) IAM environments means:

• Paying for duplicate licenses across vendors.
• Supporting excess server infrastructure and domain controllers.
• Allocating staff to manage multiple directories and policies.

By consolidating AD and centralizing IAM, healthcare organizations can retire legacy infrastructure, cut licensing duplication, and reduce overhead tied to managing fragmented systems.

Key stat: Organizations that consolidate identity platforms reduce IT infrastructure costs by up to 25 percent in the first 12 months (Gartner, 2022).

2. Reducing Help Desk and Support Costs

Healthcare staff are constantly moving across systems—whether it’s clinicians accessing EHR platforms, or admin staff navigating HR systems, billing platforms, and more.

When identity systems are fragmented, password resets, access provisioning, and system lockouts increase dramatically. According to the Ponemon Institute, password-related issues account for 30 to 50 percent of all IT help desk tickets in large healthcare systems (Ponemon Institute, 2023).

Centralized IAM with self-service capabilities, Single Sign-On (SSO), and automated provisioning dramatically reduces the burden on support teams. That means:

• Fewer password reset calls.
• Faster onboarding for new employees.
• Less downtime for clinicians and staff.

Key stat: Organizations with SSO and automated provisioning reduce help desk volume by 20 to 30 percent and save an average of $70 per employee per year in support costs (Okta Business Value Report, 2022).

3. Streamlining Compliance and Reducing Audit Burden

HIPAA, HITRUST, and increasingly, NIST-aligned frameworks, require strict governance over who has access to what and how that access is controlled, monitored, and revoked.

In a fragmented AD environment, access reviews are manual, inconsistent, and often out of date. Audit prep consumes weeks. And misaligned policies across multiple domains increase the risk of failed compliance reviews and fines.

Centralized IAM enables unified policy enforcement, consistent access logs, and real-time visibility across all systems and users. AD consolidation makes it easier to apply standardized group policies, role-based access control, and audit trails.

Key stat: Organizations with centralized IAM and AD consolidation reduce compliance audit preparation time by 40 percent and decrease regulatory risk by nearly 50 percent (IDC, 2023).

4. Avoiding the High Cost of Security Incidents

Healthcare remains the most targeted industry for cyberattacks, with the average data breach in the sector costing $10.93 million—more than double the global average (IBM Security, 2023).

Disjointed identity systems are a major contributor to this risk:

• Orphaned accounts are not deprovisioned across systems.
• Privilege creep allows former employees or contractors to retain access.
• Inconsistent authentication policies create exploitable weaknesses.

A centralized IAM strategy with strong identity lifecycle management, MFA, and automated deprovisioning significantly reduces these vulnerabilities

Key stat: Healthcare organizations with mature IAM programs experience 60 percent fewer identity-related incidents and reduce breach response costs by over $1 million on average (Ponemon Institute, 2023).

5. Accelerating Time to Value Post-Merger

Every month spent running redundant IT systems delays the financial benefits the merger was supposed to create. A unified AD and IAM environment accelerates the timeline for integrating applications, harmonizing roles, and enabling true workforce mobility.

This isn’t just a technical benefit—it’s financial. It means:

• Faster unification of revenue cycle management.
• Earlier roll-out of integrated care coordination platforms.
• Quicker decommissioning of high-cost legacy systems.

The cost of delay is real. KPMG found that healthcare organizations lose an average of $300,000 to $500,000 per month in unrealized synergies due to delayed IT integration post-merger (KPMG, 2021).

IAM and AD aren’t just pieces of the puzzle—they are the connective tissue that allows all other systems to work in sync.

Conclusion: IAM as a Strategic Cost Lever in Healthcare M&A

Most healthcare executives understand the need to consolidate identity systems eventually—but few recognize how much money is being lost by not doing it immediately.

Centralized IAM and AD consolidation are no longer optional technical projects. They are strategic imperatives with a direct impact on the bottom line. They cut operational costs, reduce IT complexity, improve compliance readiness, and secure the organization against rising cyber threats.

In a healthcare landscape where efficiency and agility are critical—and where M&A activity shows no signs of slowing—IT leaders must position identity as not just a security measure, but a powerful driver of cost savings and long-term value.

The organizations that lead in M&A success are the ones that recognize this early—and act accordingly.

Sources:

• Forrester Research, 2023. “IT Cost Inefficiencies in Post-Merger Environments.”
• Gartner, 2022. “Cost Benefits of Identity Platform Consolidation.”
• Ponemon Institute, 2023. “The True Cost of Password Problems in Healthcare.”
• IBM Security, 2023. “Cost of a Data Breach Report.”
• IDC, 2023. “Compliance Management and the Role of Centralized IAM.”
• Okta, 2022. “Business Value of Identity Modernization.”
• KPMG, 2021. “Post-Merger IT Integration in Healthcare: The Untapped Value.”