The Balanced Scorecard (BSC) is a performance measurement management control tool model that can play a critical role in driving companies to achieve sustainable performance in the healthcare industry. In the previous studies, BSC advocates that the sustainable growth of business relies on a management balance focused on financial and non-financial aspects. This study uses the BSC model to examine the core business strategies, namely the duration of CEO tenure, the spending patterns between marketing and Research & Development (R&D) and human resources capability expressed in employee size in the healthcare industry in China. The research used a sample of 305 public-listed healthcare companies in PRC China with data collected for 2016–2019 from the China Stock Market & Accounting Research Database (CSMARD). The data was analyzed by SmartPLS version 3.3.6. This study has three essential findings. First, R&D investment has a negative quadratic impact on marketing expenses. Second, marketing expenses are a mediator between R&D investment and company performance. The last finding is that CEO tenure has a moderating effect on employee size in the company. These findings add to the literature on mediation studies in leadership and management. This study provides insights into mapping BSC as an international management assessment tool, indicating potential research opportunities and highlighting managerial implications.
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