The surge in hospital closures and service eliminations negatively affect hospitals’ mission to provide life-saving services to patients. Financially struggling hospitals become acquisition targets for large multihospital systems (MHSs). Acquisitions promise to return the struggling targets to financial stability, but they also threaten to reduce services and restrict patients’ access to hospital services. Some MHSs avoid such negative outcomes and even expand the targets’ service lines, while others opt to shut down or consolidate the service lines. There is a shortage of research on which MHS and target characteristics affect such decisions. We hypothesize that the target’s service digitization level and the MHS’s enterprise-wide information technology (IT) and analytics platforms affect whether the target’s services are eliminated, expanded, or consolidated after a merger and acquisition (M&A) deal. We tested the hypotheses in a sample of 688 target hospitals acquired by 209 MHSs during the period between 2007 and 2018 using a generalized difference-in-differences strategy and the coarsened exact matching method. We found that the target’s digitization level interacts with the MHS’s analytics and IT platforms to jointly determine how service lines are changed at the target following the M&A transaction. Contrary to the extant assumptions, the target’s rural/urban status, financial performance, and service similarity with the MHS do not affect the service elimination, expansion, or consolidation outcomes. To achieve the financial goals of the M&A deal without compromising patients’ access to services, hospitals need to promote service digitization whereas MHSs need to create enterprise-wide IT and analytics platforms.