This chapter explores the theoretical and analytical foundations for making successful restructuring decisions. It introduces Managed Services Restructuring (MSR), a deliberate and orchestrated management effort. MSR provides the procedures that avoid last-ditch efforts to save an unsalvageable situation and are the least damaging to the institution and the public. A review of the Product Life Cycle Theory and Portfolio Analysis will assist in understanding the MSR concept. The MSR analysis of a service must take into account what type of hospital is being analyzed and where the service is in regard to its life span. Robert L. Goldman and Jean E. Schore, in developing the concept of managed service restructuring, observed that the demand for acute hospital services is declining. The change in the legal environment, that is, changes in the Medicare Fraud and Abuse regulations, have placed traditional hospital-physician joint ventures in jeopardy. The chapter also presents an overview of the key concepts discussed in this book.