This case study deals with a regional college of health care education that has been acquired by a private education operator. The focus is on tools such as the Balanced Scorecard, target costing, cost of quality, and Value-based Management. The case can serve as both a discussion basis in class as well as an exam for students in management, operations, strategy, health care, and accounting. The case illustrates how business managers and medical faculty can jointly optimize strategy execution in a college, analyze the value-creating components of the curriculum, and understand the dynamics of investing into higher quality. The open questions at the end of the case study allow for an adjustment to the level of knowledge of the students. They also serve the purpose of raising students’ awareness of the limits of traditional financial control in hybrid, social enterprises. Students will need to reflect on how random cost reductions conflict with employer expectations, the mission of a college and the policies of regulators.