New Hyde Park, N.Y.-based Northwell Health and Danbury, Conn.-based Nuvance Health have officially merged, forming an integrated regional health system that spans from New York City to western Connecticut — a move Northwell President and CEO Michael Dowling says has been nearly a decade in the making.
Five things to know:
1. The integrated system now has a $22.6 billion operating budget, 28 hospitals, more than 104,000 employees — including 22,000 nurses and 13,500 providers — as well as over 1,050 ambulatory care sites and 73 urgent care centers.
2. As part of the transaction, Northwell will invest at least $1 billion in Nuvance hospitals, which include:
- Danbury (Conn.) Hospital
- New Milford (Conn.) Hospital
- Norwalk (Conn.) Hospital
- Sharon (Conn.) Hospital
- Northern Dutchess Hospital (Rhinebeck, N.Y.)
- Putnam Hospital (Carmel Hamlet, N.Y.)
- Vassar Brothers Medical Center (Poughkeepsie, N.Y.)
3. Mr. Dowling continues to lead Northwell. Nuvance President and CEO John Murphy, MD, remains in leadership, though further structural updates for the combined organization have yet to be announced.
4. The transaction is the 21st acquisition Northwell has completed since it was founded in 1997, according to Mr. Dowling. Nuvance formed in 2019 with the merger of LaGrangeville, N.Y.-based Health Quest and Danbury-based Western Connecticut Health Network.
5. Both Northwell and Nuvance reaffirmed their commitments to the goals and objectives of the new integrated health system:
- Expand care access: Patients will gain improved access to coordinated care across 1,050+ sites in Connecticut, New York City, Long Island, and the Hudson Valley, covering ambulatory, hospital, and post-acute services.
- Improve community health: The combined system aims to address health disparities and improve outcomes through more efficient, responsive and inclusive care — with a continued commitment to serving all patients, regardless of ability to pay.
- Advance innovation and research: Nuvance will use Northwell’s clinical, technical and financial resources to drive medical innovation and accelerate advancements in patient care and research.
- Attract and grow talent: The integration expands opportunities to recruit top medical and research talent while supporting career development, academic pathways and workforce pipeline initiatives across both systems.
A merger nearly a decade in the making
In an interview with Becker’s, Mr. Dowling described the merger as the latest step in Northwell’s long-term regional growth strategy.
“Northwell has had a consistent growth strategy for years — we’ve completed 21 acquisitions so far,” he said. “The Nuvance integration is just the latest major step in that broader expansion. Our goal has always been to build a strong regional health system. Nuvance is geographically contiguous to the rest of our organization.”
Talks with Nuvance began about eight years ago, but were paused during the COVID-19 pandemic. “We’ve had a strong relationship over time,” Mr. Dowling said. “COVID delayed things, but we’ve always shared a similar vision.”
Integration work is already underway. Over the past two years, nearly 50 joint work groups between the two systems have met to exchange plans on quality, infrastructure, HR and technology, among other operational areas. “Now that the merger is official, we can begin implementing the plans we’ve developed,” he said.
While the operational work is substantial, Mr. Dowling emphasized that relationships and trust are the cornerstone of successful mergers.
“It’s essential to listen, understand where you’re going, and build trust,” he said. “It’s all about relationships and connections. We’re committed to making this a win-win — not a win-lose — and that process is now fully underway.”
Northwell’s regional vision — and what’s next
Mr. Dowling described Northwell’s core catchment area as encompassing “where people come from to work in Manhattan — Connecticut, upstate New York, New Jersey, Pennsylvania, Staten Island, and Long Island.” Expansion efforts are already underway in parts of Pennsylvania and upstate New York, with more expected in the coming years.
“Ultimately, we want Northwell to be the most integrated, comprehensive health system across that entire region — offering all services, across all stages of life, for all communities,” he said.
While the system’s main focus remains in the Northeast, Northwell has also opened a small facility in Palm Beach, Fla., serving seasonal residents. Mr. Dowling said future expansion in Florida is likely, though regional growth remains the priority.
“Any health system that’s innovative and focused on long-term success should be thinking about growth and market expansion,” he said. “We’re already the largest health system and the biggest employer in New York. But I welcome competition — it keeps us sharp. When others move into your space, it forces everyone to get better. Innovation thrives under pressure.”
The rise of multi-region health systems
Healthcare continues to move toward a multi-region model, and Mr. Dowling believes the future will be defined by large, integrated health systems that operate across multiple states.
“Looking 10 years ahead, I believe the majority of healthcare in the U.S. will be delivered by 30 to 40 large, integrated systems,” he said. “Consolidation will continue. Some of those systems will merge, others will partner — and we’re currently in some of those discussions ourselves.”
While some may view consolidation — and what it means for independent hospitals, competition and patient access — skeptically, he sees it as a necessary evolution.
“The more integrated we become, the better we can deliver seamless care across the full continuum,” he said. “While no two systems are exactly alike, we can complement one another’s strengths.At Northwell, we’re quite different from other systems in our area, that’s what makes these partnerships work.”
Advice to CEOs weighing M&As
Mr. Dowling offered measured advice for health system leaders pursuing mergers, acquisitions or partnerships.
“Study the opportunity carefully. Build real relationships. Don’t make reactive decisions — take the time to ensure it’s the right move,” he said. “If you’re going to partner with another organization, it can’t be about telling them what to do. It has to be a true collaboration — a win-win. Move with intent, but also with caution. Be creative and willing to take some risk, but stay grounded. Trust, respect, and integrity are essential.”
Ultimately, scale must serve purpose.
“This isn’t about being a ‘Pac-Man’ organization — growing just for the sake of growth” he said. “Mergers should be about improving healthcare for the communities you serve. Being the biggest is fine — but what matters most is being the best.”
