Financial pressure is accelerating consolidation at a pace not seen in years. Staffing shortages, aging infrastructure, heavy Medicaid and Medicare dependence, and mounting payer denials have left hundreds of community hospitals with a stark choice: find a partner or close.
Academic health systems, large nonprofits and regional powerhouses are all moving aggressively to absorb distressed and independent facilities, expanding geographic footprints, offloading debt and locking in patient pipelines in the process.
Here are 32 academic health systems that have announced or plan to close strategic mergers, acquisitions or partnerships this year:
1. Little Rock-based University of Arkansas for Medical Sciences Health plans to sign a co-management agreement with Mena (Ark.) Regional Health System and take over operations of Encore Medical Center, a 53-bed facility in Bryant, Ark. UAMS also has reached a co-management agreement with Helena (Ark.) Hospital, which is awaiting state approval.
2. UC San Diego Health and Escondido, Calif.-based Palomar Health on July 1 completed a joint powers authority, forming a new health system called Palomar UC San Diego Health. The new entity oversees Escondido and Poway hospitals, but Palomar UC San Diego Health and UC San Diego Health remain separate systems with independent licenses and medical staffs. Diane Hansen, who served as CEO of Palomar Health, will serve as CEO of the JPA.
3. Pittsburgh-based Allegheny Health Network acquired Heritage Valley Beaver and Heritage Valley Sewickley, effective July 1. which became the 15th and 16th hospitals in the health system’s network. As part of the affiliation, Allegheny Health Network — a subsidiary of Highmark Health— became the sole corporate member of Heritage Valley Health System.
4. Edison, N.J.-based Hackensack Meridian Health signed a June 22 letter of intent to explore the acquisition of Flemington, N.J.-based Hunterdon Health. Hunterdon Health includes its flagship hospital, Hunterdon Medical Center, and a network of more than 30 medical practices across central New Jersey. Hackensack Meridian Health comprises 18 hospitals, more than 500 care sites and 40,000 employees.
5. Chapel Hill, N.C.-based UNC Health, a 16-hospital system, plans to take over Onslow Memorial Hospital, a 162-bed facility in Jacksonville, N.C., under a strategic affiliation agreement approved June 15 by the Onslow County Board of Commissioners. Effective July 1, UNC Health will gain a 30% membership interest in the hospital and an expanded operational role. A second phase will increase UNC Health’s membership interest to 49%. A third and final phase, set for 2029, would make UNC Health the sole member of Onslow Memorial.
6. Winston-Salem, N.C.-based Novant Health acquired Danbury, N.C.-based Community Hospital of Stokes, a 53-bed critical access hospital, effective June 1. The acquisition expands Novant’s presence in Stokes County, which already included multiple primary and specialty care clinics.
7. Irving, Texas-based Christus Health took over operations May 1 at Mount Pleasant, Texas-based Titus Regional Medical Center, a 174-bed hospital.
8. Memphis, Tenn.-based Baptist Memorial Health Care will assume operations of Merit Health Rankin, a 134-bed hospital in Brandon, Miss., later this year, adding a 26th hospital to the nonprofit system. Earlier this year, Baptist Memorial Health Care acquired Paragould-based Arkansas Methodist Medical Center and OCH Regional Medical Center in Starkville, Miss. The transactions increase the number of hospitals in the system’s portfolio to 26. The system operates hospitals in Tennessee, Arkansas and Mississippi.
9. Morgantown, W.Va.-based WVU Health System plans to acquire Greensburg, Pa.-based Independence Health System, which operates five hospitals. The transaction, which is projected to close this fall, would see WVU Health expand significantly in Pennsylvania and increase the number of hospitals in its footprint to 30.
10. Opelika, Ala.-based East Alabama Health assumed operations and management of Bullock County Rural Emergency Hospital in Union Springs, Ala., effective June 1. The move came after the rural emergency hospital’s previous operator notified local leaders it would depart, prompting efforts to maintain access to emergency and outpatient care in the community.
11. Atrium Health, part of Charlotte, N.C.-based Advocate Health, plans to merge with Raleigh, N.C.-based WakeMed Health & Hospitals. Under the proposed deal, Advocate Health said it would invest $2 billion in Wake County to expand facilities, add jobs and increase access to care.
12. Sacramento, Calif.-based Sutter Health plans to acquire Minneapolis-based Allina Health, creating a combined nonprofit organization spanning California, Minnesota and Wisconsin. The proposed transaction would create a $26 billion system that would include 39 hospitals, more than 400 care sites and 88,000 employees. The deal is expected to close by the end of 2026, pending regulatory approval.
13. Pittsburgh-based UPMC plans to acquire Steubenville, Ohio-based Trinity Health System, a three-hospital system owned and operated by Chicago-based CommonSpirit. The acquisition would see UPMC enter the Ohio hospital market.
14. Nashville, Tenn.-based Vanderbilt Health acquired CHS’ 80% ownership interest in two joint ventures that own and operate Tennova Healthcare-Clarksville (Tenn.). The $600 million deal, announced Oct. 30, includes the 270-bed hospital in Clarksville and ancillary businesses.
15. Orlando (Fla.) Health plans to acquire Anniston, Ala.-based RMC Health System, continuing its push into Alabama. RMC is a nonprofit system that includes a 375-bed medical center, 200 physicians and nearly 2,000 employees. The transaction is expected to close this fall, with RMC joining Orlando Health’s Alabama Region alongside Baptist Health.
16. Farmington, Conn.-based UConn Health acquired Waterbury (Conn.) Hospital from bankrupt Los Angeles-based Prospect Medical Holdings on March 1, establishing the UConn Health Community Network. The network includes Waterbury Hospital, now known as UConn Health Waterbury Hospital, along with the UConn Health Community Network Medical Group and UConn Health Waterbury Health at Home. UConn Health also plans to acquire Middletown, Conn.-based Solnit Hospital, a children and adolescent psychiatric facility, into a satellite location of its UConn John Dempsey Hospital in Farmington.
17. Tampa (Fla.) General Hospital plans to assume operations of DeSoto Memorial Hospital, a 49-bed rural facility in Arcadia, Fla., under a 49-year lease at $10 per year that includes a purchase option. DeSoto Memorial reported a $538,432 operating loss (-1.2% margin) in fiscal 2024 and derives roughly 65% of its revenue from Medicare and Medicaid.
18. The board of trustees of Florida State University approved the acquisition of Tallahassee (Fla.) Memorial HealthCare from the city, with the Florida Board of Governors following suit shortly after. The March 26 approvals pave the way to convert the city-owned hospital into an integrated academic medical center.
19. Hartford (Conn.) HealthCare acquired Manchester (Conn.) Memorial Hospital from Los Angeles-based Prospect Medical Holdings on Jan. 1. The acquisition follows Prospect Medical Holdings’ Chapter 11 bankruptcy filing in January 2025 and a previously failed attempt by Yale New Haven (Conn.) Health to acquire Manchester Memorial. Hartford HealthCare was ultimately named the sole bidder and buyer.
20. Little Rock, Ark.-based Baptist Health signed a definitive agreement to acquire South Arkansas Regional Hospital, a 151-bed facility in El Dorado. The acquisition would see Baptist Health increase the number of hospitals in its footprint to 13.
21. Portland-based MaineHealth plans to acquire York Hospital, a 79-bed independent facility. Rising labor costs, escalating pharmaceutical and supply expenses, and increasing payer denials have forced the independent hospital to seek a health system partner.
22. New York City-based Montefiore Health System and Garnet Health have signed a letter of intent for Garnet to join the academic health system through a strategic affiliation. Garnet Health, a three-hospital system headquartered in Middletown, N.Y., serves more than 500,000 residents across New York’s mid-Hudson and Catskills regions. Montefiore operates 10 hospitals and more than 200 outpatient sites.
23. Corvallis, Ore.-based Samaritan Health Services plans to merge with Tacoma, Wash.-based MultiCare Health System, creating an 18-hospital system with more than 33,000 employees. The transaction, which is expected to close in mid-2026, would bring Samaritan under the MultiCare umbrella.
24. Lebanon, N.H.-based Dartmouth Health signed a letter of intent in September to acquire Littleton (N.H.) Regional Healthcare, a 25-bed critical access hospital. Dartmouth also recently added Claremont, N.H.-based Valley Regional Hospital, a 25-bed facility, to its network.
25. Charleston, S.C.-based MUSC Health is moving closer to acquiring majority ownership of Georgetown, S.C.-based Tidelands Health. Under the agreement, the Medical University Hospital Authority will acquire a majority membership interest in Tidelands Health, deepening integration of services, technology and clinical expertise. The proposed deal cleared several regulatory hurdles in August, receiving approvals from the Joint Bond Review Committee, the State Fiscal Accountability Authority and both systems’ boards.
26. Billings (Mont.) Clinic plans to affiliate with Sheridan (Wyo.) Memorial Hospital, an 88-bed acute care facility, after the Sheridan County Board of County Commissioners unanimously approved an agreement in March. Billings Clinic merged with Kalispell, Mont.-based Logan Health; the combined independent system now encompasses 25 hospitals, including 16 regional partnerships with critical access hospitals and clinics.
27. West Orange, N.J.-based RWJBarnabas Health in January signed a definitive agreement to acquire Englewood Health. Under the agreement, RWJBarnabas Health would invest about $500 million in Englewood Health to support expanded outpatient services and community health programs, as well as other strategic investments.
28. NYC Health + Hospitals, New York City’s public health system, plans to acquire Brooklyn, N.Y.-based Maimonides Health. Maimonides and NYC Health + Hospitals are continuing to work with stakeholders toward a final deal, which would see NYC Health + Hospitals become a 14-hospital system.
29. Worcester, Mass.-based UMass Memorial Medical Center acquired Marlborough (Mass.) Hospital, effective Jan. 1. The 79-bed hospital was renamed UMass Memorial Medical Center–Marlborough Campus.
30. Rockford, Ill.-based Mercyhealth acquired Freeport, Ill.-based FHN, a 100-bed hospital with eight outpatient facilities, effective Jan. 1.
31. Jackson-based University of Mississippi Medical Center is exploring a potential takeover of Greenwood (Miss.) Leflore Hospital. UMMC recently acquired Merit Health Madison, a 67-bed facility in Canton, Miss.
32. San Antonio-based University Health plans to purchase Christus Santa Rosa Hospital-Medical Center, which closed earlier this year, from Irving, Texas-based Christus Health.
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