Franklin, Tenn.-based Community Health Systems is closer to exiting the Pennsylvania market after state regulators on Jan. 28 approved a plan for the for-profit system to sell its three hospitals to Tenor Health Foundation.
The deal was first announced in October and was one of the 11 deals struck in 2025 that involved a for-profit system as a seller, according to Kaufman Hall. Only one deal announced last year involved a for-profit system as the acquirer.
Kaufman Hall said it expects for-profit systems to continue divesting non-core assets, citing a growing realization that scale alone is no longer a sufficient growth or margin strategy without market or regional-level density.
CHS CEO Kevin Hammons told Becker’s in December that beginning in the late-2010s, the system pivoted toward “building networks of care — markets where we could leverage our scale and footprint, either within a state or a defined region.”
“This approach allowed us to build out access points across the continuum, from primary care to acute care and into post-acute services,” Mr. Hammons said. “Many of the hospitals we’ve divested didn’t fit into that network-of-care strategy. Refocusing has allowed us to hone in on our core markets, where we have the full continuum of care and can truly leverage our scale.”
CHS has continued that approach in 2026, announcing Jan. 20 that it signed a definitive agreement to sell Crestwood Medical Center in Huntsville, Ala., to Huntsville (Ala.) Hospital Health System for $450 million.
Another for-profit system, Brentwood, Tenn.-based Quorum Health, reached an agreement early in 2026 to sell Big Spring, Texas-based Scenic Mountain Medical Center to San Angelo, Texas-based Shannon Health System. The deal follows Shannon’s 2024 purchase of West Texas Medical Plaza, where Scenic Mountain Medical Group is located.
In 2024, Dallas-based Tenet Healthcare sold 14 hospitals. In an April earnings call from that year, Tenet CEO Saum Sutaria, MD, called the moves a “dawn of a new era” for the for-profit system.
“While our mission to provide quality, compassionate care in the communities we serve has not changed, we are essentially a new company,” Dr. Sutaria said. “Our repositioned portfolio of businesses is more predictable and capital efficient with attractive margins and free cash flow. The operational discipline that we have instilled in each of our facilities, enabled by an analytics-driven culture, is producing differentiated results.
“Our balance sheet, which was once a challenged part of Tenet’s story, has been deleveraged. This provides us with a strong foundation and a significant amount of capital and financial flexibility for the future.”
Nashville, Tenn.-based HCA Healthcare has bucked the trend set by Tenet and CHS in recent years. Between 2019 and 2024, HCA grew from 178 hospitals to 190. That number remained flat in 2025.
HCA CEO Sam Hazen said on the system’s Jan. 27 earnings call that they have not seen significant opportunities that make sense financially.
“We continue to be well-positioned with our balance sheet being in a great position,” he said. “The capabilities of the company as a scale player allows us to assimilate individual hospitals or hospital systems synergistically, but we haven’t seen [opportunities]. We are obviously open to those types of transactions if and when they present themselves.”
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