A more and more widespread formalization of the Operational Management (OM) function in the organizational structures of the Public Health Companies (ASP) of the National Health Service (OASI 2017 Report) has been underway for some years now. In 2018 the research set out to analyze how the OM functions are structured and what activities / projects they are undertaking to achieve the objectives and the mission assigned to it by the company. The aforementioned functions established in four ASPs were then analyzed, through the study of company documentation and interviews with operational managers, team members and, possibly, the General Management. The choice fell on four different realities in terms of professionalism involved (engineers, nurses, medical managers), organizational forms and functions submitted. The realities examined are ASST Bergamo Ovest, ASST Cremona, ASST Monza and AUSL Reggio Emilia. The analysis shows how the functions have a common mission: to move from a planning and fragmented management of the assets and production processes to a more centralized, uniform and consistent with company strategies. The functions of GO analyzed present some similar traits in terms of assigned responsibilities. From an organizational design, they plan the use of outpatient assets, operating rooms and hospitalizations, they carry out internal consultancy with respect to the management downstream of production assets and in the development of projects on patient pathways. Another aspect in common is represented by the area on which they acted initially, namely the surgical one (mainly on the operating theater programming, waiting lists management, reorganization of the pre-hospitalization). In a context of inevitable resistance to change, the functions are fully at work and the first results are encouraging. Among the facilitating factors: a solid methodological approach, the multidisciplinary connotation of the team (restricted or enlarged), the investment (technological as well as organizational) on the information systems and the commitment of the strategic direction. The OM is therefore proposing to become one of the central functions of this phase of corporatization; for those who have already taken this path, the next challenge will be how to extend the activities to the other areas of patient logistics and H-T integration.