ABSTRACT During M&A (mergers and acquisitions), a frequent outcome is the negative reactions of workers, who demonstrate psychological distress and resistance to change. This paper presents an empirical research study carried out in a large Italian university hospital during an organizational restructuring, which led to the merger of several organizational units. The research involved a sample of healthcare operators as change recipients (N = 130), and investigated the relationship between Readiness to Change and change recipients’ reactions. By adopting a Structural Equation Model approach, this study suggests that the relationship between Readiness To Change and Change Cynicism, Change Anxiety and Intention To Quit, is complex and not always direct and linear. Furthermore, this paper shows the role that Change Cynicism plays in mediating the relationship between Readiness To Change and Change Anxiety and between Readiness To Change and Intention To Quit. This study highlights the importance of investigating and systemically addressing the relationship between these factors. MAD statement This article sets out to Make A Difference (MAD) through analysing the mechanisms underlying the affective and emotional reactions of change recipients. It provides an important practical contribution for practitioners, as it suggests how to manage the variables that intervene in a process of radical organizational change in an appropriate manner. This article has significant consequences, also at a societal level. It highlights the factors that should be managed to avoid undesired, negative organizational and corporate consequences such as states of change anxiety and the Intention To Quit.