Chicago-based CommonSpirit Health has sold or is working to sell eight hospitals in 2026 as the 136-hospital system reshapes its national footprint and pushes to improve operating performance.
The activity spans Ohio and North Dakota and comes alongside a broader restructuring that includes consolidating five regions into three service areas, bringing revenue cycle operations in-house and targeting billions of dollars in financial improvement through its Project ImpACT initiative.
CommonSpirit completed one of its largest portfolio moves Oct. 1, selling Steubenville, Ohio-based Trinity Health System to Pittsburgh-based UPMC. The transaction gave UPMC its first hospital operations in Ohio and included Trinity West and Trinity East in Steubenville, Trinity Twin City Medical Center in Dennison and Trinity St. Clairsville Neighborhood Hospital.
Financial terms of the deal were not disclosed.
CommonSpirit has also been reducing its hospital footprint in North Dakota. Grand Forks-based Altru Health System acquired CHI St. Alexius Health Devils Lake, a 25-bed critical access hospital, from CommonSpirit effective March 1.
Three additional North Dakota hospitals could follow. CommonSpirit plans to sell CHI St. Alexius Health in Bismarck, CHI St. Alexius Health Turtle Lake and CHI St. Alexius Health Garrison to Altru Health by the year’s end.
The hospital sales take place as CommonSpirit makes broader structural changes across the organization. Effective in January 2027, the system will consolidate its five regions into three service areas — West, Central and East — as it looks to eliminate duplication, management layers and complex legal structures. CommonSpirit is also consolidating acute care entities into one entity per state and bringing its 27 critical access hospitals under a single rural operating model within the East service area.
The restructuring is part of Project ImpACT, through which CommonSpirit now projects $6 billion in financial improvement over five years. The system is targeting more than $1 billion in fiscal 2027 efficiencies through workforce changes, clinical standardization, supply chain adherence and purchased-services standardization, according to CFO Michael Browning.
CommonSpirit is also exiting its relationship with Conifer Health Solutions and bringing revenue cycle operations in-house. More than 1,900 employees are being rebadged as part of the transition, which is scheduled to be completed Oct. 30.
The system’s underlying operating performance improved in fiscal 2026. CommonSpirit reported a $430 million operating loss, or -1% margin, before special charges, compared with a $687 million loss and -1.8% margin a year earlier. Revenue increased 8.5% to $42.4 billion. Including $2.8 billion in special charges, however, CommonSpirit posted a $3.2 billion operating loss. About $2.3 billion of those charges were tied to its Conifer exit, with additional costs associated with brand unification and restructuring.
The hospital sales, regional consolidation and revenue cycle overhaul point to a system becoming more selective about where and how it operates as it seeks to simplify its structure and improve margins.
