Zero-Cost-Based Management Theory: A Conceptual Framework for Organizational Transformation.

Escalating costs, particularly in healthcare, have intensified the need for approaches that improve performance while preserving financial sustainability. Existing models such as zero-based budgeting (ZBB), zero-based cost management (ZBCM), and value-based management emphasize expenditure control and efficiency but often assume the availability of resources for implementation. This paper introduces Zero-Cost-Based Management Theory (ZCBMT), a conceptual framework explaining how organizations can achieve meaningful organizational change with minimal additional financial investment. The theory is built on three principles: optimization of existing resources, elimination of low-value activities, and mobilization of internal organizational capabilities. Rather than focusing solely on cost reduction, ZCBMT emphasizes value maximization-achieving optimal outcomes at the lowest feasible cost-through resource reallocation, process redesign, digital innovation, evidence-based practices, and collaborative capacity. The framework provides a pathway for sustainable transformation in resource-constrained environments while emphasizing organizational resilience, ethical considerations, and equitable access to services. ZCBMT may offer a practical approach for organizations seeking performance improvement when financial resources are limited.