“Growth” in 2026 no longer means adding more beds. It means shedding the wrong ones.
Some of the country’s largest nonprofit health systems are divesting hospitals at the same moment for-profits are reshaping their portfolios — and the CEOs driving those decisions are converging on the same logic: Focus where the system can do the most good, and let go of the rest.
Chicago-based CommonSpirit Health has moved quickly in 2026. In May, it signed a definitive agreement to transfer Steubenville, Ohio-based Trinity Health System, which includes several hospitals and clinics, to Pittsburgh-based UPMC. In March, it sold a 25-bed critical access hospital in Devils Lake, N.D., to Grand Forks, N.D.-based Altru, and is in the process of selling three more hospitals to Altru.
Renton, Wash.-based Providence is considering selling its insurance arm, Providence Health Plan, and in April the system signed a definitive agreement to sell Queen of the Valley Medical Center in Napa, Calif., to Fairfield, Calif.-based NorthBay Health.
Meanwhile, Livonia, Mich.-based Trinity Health has signed a definitive agreement to sell Mercy Medical Center in Springfield, Mass., to Baystate Health.
The executives framing these deals are expressing similar priorities: focusing on where the system “fits” best rather than where it can grow largest.
“The process is really around us looking at market position, market potential,” said Lisa Zuckerman, CommonSpirit’s senior vice president of treasury and strategic investing. “Is a market better served by us? Or do we think that another organization would provide the community with a better future? And that was the case in all three of [these deals].”
Laureen Driscoll, chief executive of Providence South Division, shared similar priorities in announcing the NorthBay transaction.
“As Providence pursues its 2030 strategic direction, we recognize that we must focus our resources where we can do the greatest good,” Ms. Driscoll said. “We are confident that NorthBay Health is the right organization to build on the Queen’s legacy and continue the commitment to exceptional care for the Napa community.”
For-profit systems are arriving at the same conclusion through a different strategy.
Dallas-based Tenet Healthcare has expanded its ambulatory surgery center footprint, deploying $125 million in first-quarter 2026 to acquire seven ASCs as systems across the country shift investments from inpatient beds to ambulatory facilities. Nashville, Tenn.-based HCA Healthcare, acquired two hospitals and sold two hospitals in 2025.
Franklin, Tenn.-based Community Health Systems plans to divest nine hospitals across four states in 2026 for more than $1.2 billion total — and has sold about 35% of its hospital portfolio in recent years.
“Many of the hospitals we’ve divested didn’t fit into our network-of-care strategy,” CHS CEO Kevin Hammons told Becker’s. “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.”
Tax status and deal structure aside, both groups are doing the same thing: portfolio rationalization.
It is also how a growing number of health system CEOs are defining growth itself.
Timothy Pehrson, CEO of Oklahoma City-based Integris Health, calls it “smart growth” — focusing on health value rather than volume at all costs and avoiding acquisitions likely to dilute margin, stretch operations too thin or fail to improve community health.
“The discipline is what to say ‘no’ to, because there’s lots of opportunities out there,” Mr. Pehrson said. “The question for us isn’t, ‘Can we grow here?’ It’s, ‘Does this make us stronger in ways that help us better serve Oklahomans?’ You might be able to grow in a non-core market, but does that make you stronger operationally? If it creates distraction, then does that make sense?”
Houston Methodist President and CEO Marc Boom, MD, said the system does not try to be the biggest — it strives to be the best.”Growth means more than just expanding our footprint. It’s growing in ways that best serve our patients” Dr. Boom told Becker’s. “What no longer counts is checking boxes to simply say you have a presence in that area.”
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