61 Integrated Health Systems to Know

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Becker's Hospital Review has named "61 Integrated Health Systems to Know" based on organizations' access to care, physician alignment and inclusion of numerous and varied services along the continuum of care. The systems have been recognized for integrated care by healthcare analytics company SDI, peer institutions via nominations and through careful research by the Becker's Hospital Review editorial team. Note: This list is not an endorsement of included health systems or associated healthcare providers, and health systems cannot pay for inclusion on this list. Health systems are presented in alphabetical order.

Advocate Health Care (Oak Brook, Ill.). Advocate Health Care is the largest integrated healthcare system in Illinois and one of Chicagoland's largest employers, with more than 30,000 employees and affiliated physicians. Advocate includes roughly 6,000 affiliated physicians, making it the state's largest network of primary care physicians, specialists and sub-specialists. Advocate physicians and other healthcare providers serve patients at more than 250 sites of care, including 10 acute-care hospitals, two children's hospitals and a variety of outpatient centers. In October, Advocate Christ Medical Center in Oak Lawn, Ill., opened a new $202 million Outpatient Pavilion. Advocate also has academic and teaching affiliations with all major universities in the Chicago metropolitan area.

Alegent Health (Omaha, Neb.). Alegent Health is the largest non-profit, faith-based healthcare provider in Nebraska and southwest Iowa, providing care at more than 100 sites. In addition to its nine hospitals, the system has multiple clinics, including urgent care clinics, three wellness centers and six pharmacies. The Alegent Health Clinic is a network of more than 250 physicians who provide care at 70 locations. Overall, Alegent Health has 1,300 physicians and 8,600 employees.

Aurora Health Care (Milwaukee). Aurora Health Care offers care at 15 hospitals; 185 clinics; 82 retail pharmacies; multiple diagnostic, treatment and rehabilitation centers; and home healthcare and social services agencies. As the largest private employer in Wisconsin, Aurora has roughly 30,000 caregivers, 1,400 employed physicians and 3,067 physicians on staff. Aurora is also affiliated with the University of Wisconsin Medical School and Medical College of Wisconsin. In June, Aurora St. Luke's Medical Center opened four specialty heart centers to treat patients with hypertrophic cardiomyopathy, adult congenital heart disease, Marfan syndrome and valvular heart disease.

Banner Health (Phoenix).
Banner Health delivers care in seven states through 23 hospitals, long-term care centers, pediatric facilities and family clinics. Banner has more than 35,000 employees and approximately 7,000 physicians on its hospitals' medical staffs. The health system has medical education programs at Banner Good Samaritan Medical Center in Phoenix and North Colorado Medical Center in Greeley and offers home care and home medical equipment services. In November, Banner became the first health system accepted by CMS for the Accountable Care Organization Pioneer Program.

Baptist Health Care (Pensacola, Fla.). Baptist Health Care is comprised of more than 6,000 employees, including physicians, making it the largest non-governmental employer in northwest Florida. The system includes four hospitals, two medical parks, a pharmacy and several other centers. Baptist Health Care also offers managed care contracting, home health and occupational health services. In 2011, Baptist Health Care celebrated its 60th anniversary and added its 100th physician to Baptist Medical Group, which includes primary care and specialty physicians.

Baptist Health South Florida (Coral Gables, Fla.).
Baptist Health South Florida is the largest faith-based non-profit healthcare organization in the region, with more than 13,500 employees and approximately 2,000 physicians. The system consists of seven hospitals and several outpatient facilities offering diagnostic, urgent care and surgical services. Baptist also includes the Baptist Health International Center of Miami, one of the largest hospital-based international programs in the country. In late April, Baptist Health opened 133-bed West Kendall Baptist Hospital, which is affiliated with Florida International University's Wertheim College of Medicine and was the first new, non-replacement hospital built in Miami in more than 35 years.

Baptist Memorial Health Care (Memphis, Tenn.). Baptist Memorial Health Care features 14 hospitals, 6 home care facilities, 6 hospice locations and four minor medical centers. The system employs 12,000 workers and has more than 4,000 physician providers. In addition, Baptist Memorial includes Baptist Health Services Group, a preferred provider organization with 54 hospitals and 200 ancillary facilities, and a multispecialty group called Baptist Memorial Medical Group. In September, BMMG formed Memphis Lung Physicians Foundation after acquiring Memphis Lung Physicians.

BayCare Health System (Clearwater, Fla.). BayCare Health System has approximately 3,100 physicians on staff and 18,500 employees and serves patients at more than 200 care locations, including 11 hospitals and approximately 70 outpatient facilities. The system's newest hospital, 108-bed St. Joseph's Hospital-North, opened in Feb. 2010 and is completely wireless. BayCare's Morton Plant North Bay Hospital opened a new 9,750-square-foot cardiovascular center in September and broke ground on a surgical center in mid-December.

Baylor Health Care System (Dallas).
Baylor Health Care offers care at more than 239 access points, including 27 owned, leased or affiliated hospitals; 26 ambulatory endoscopy centers; 69 outpatient clinics; four senior health centers; 2 retail pharmacies; and 156 access points to the HealthTexas Provider Network. HealthTexas is the largest group of employed physicians in Texas, with more than 450 primary care physicians, specialists and hospitalists. Overall, Baylor has nearly 20,000 employees and approximately 4,630 physicians on medical staff. In early November Baylor Regional Medical Center at Grapevine broke ground on a $100.5 million patient tower and expansion.

Baystate Health (Springfield, Mass.). Baystate Health employs nearly 10,000 people and has several care locations, including three hospitals, multiple outpatient centers and 580-physician Baystate Medical Practices. In addition, Baystate Medical Center is the Western Campus of Tufts University School of Medicine, which offers 10 residencies and 16 fellowships. Baystate Health is currently constructing a $296 million, 641,000-square-foot "Hospital of the Future," expected to open in March 2012. The facility will include a heart and vascular center; new patient care units with private rooms; an emergency department; and shell space for future growth.

Beaumont Hospitals (Royal Oak, Mich.). Beaumont Hospitals is a three-hospital system with a medical staff of more than 3,700 physicians and 4,000 full-time equivalent employees, making it the largest employer in Oakland County, Mich. The system also includes nursing homes, family medicine centers, rehabilitation facilities and other outpatient centers, home medical equipment stores and hundreds of physicians' offices. Beaumont Hospitals offers educational opportunities through its Oakland University William Beaumont School of Medicine and Applebaum Surgical Learning Center.

Bon Secours Virginia Health System (Richmond). Bon Secours Virginia Health System consists of Bon Secours Richmond and Bon Secours Hampton Roads with a total of seven hospitals and multiple primary care practices, ambulatory care sites and continuing care facilities. The health system employs nearly 11,000 people and Bon Secours Richmond's medical group includes more than 200 physicians at more than 70 locations. Bon Secours Richmond also includes Bon Secours Memorial College of Nursing, St. Mary's Hospital School of Medical Imaging and two family practice residency programs.

Carilion Clinic (Roanoke, Va.). Carilion Clinic is led by multi-specialty physician teams and includes 10 hospitals in addition to numerous other facilities along the continuum of care. Carilion has 600 physicians at 152 practice sites and includes approximately 11,000 employees. The health system offers two health plans — MajestaCare and Carilion Clinic Medicare Health Plan — and in March it partnered with Aetna for an accountable care organization initiative. Carilion also includes the Virginia Tech Carilion School of Medicine and Research Institute, created in partnership with Virginia Tech, and an affiliation with the Jefferson College of Health Sciences.

Carolinas HealthCare System (Charlotte, N.C.). Carolinas HealthCare System employs more than 1,400 physicians and mid-level providers at more than 600 care locations, including more than 30 affiliated hospitals. Carolinas Medical Center offers residency programs in 12 specialties, serves as an off-campus training site for three additional specialties and features the Carolinas College of Health Sciences as a subsidiary. Carolinas HealthCare System also provides Carolinas MED-1, the country's only mobile emergency center, and the air medical company MedCenter Air. In September, the health system was selected by the South Carolina Department of Health and Environmental Control to build and operate a new hospital in York County.

Catholic Health System (Buffalo, N.Y.).
Catholic Health System includes more than 8,200 full and part-time associates, 1,200 physicians, three hospitals and numerous primary care and imaging centers. The system offers the Catholic Health and Niagara University RN to BSN program and a Catholic Health Clinical Pastoral Education program. In addition, Catholic Health partnered with Mount St. Mary's Hospital in Lewiston, N.Y., and a network of nearly 900 associated physicians to create Catholic Medical Partners — the largest group of independent practicing physicians in western New York.

Community Health Network (Indianapolis).
Community Network has more than 11,000 employees and 1,400 physicians at its numerous sites of care, including six hospitals, several surgery centers, school-based clinics and other facilities. The system's Community Physicians of Indiana includes 200 primary care physicians and nurse practitioners in more than 80 locations. In November, Community Health Network entered into a joint venture with Centerre Healthcare in Nashville, Tenn., to build a $23 million inpatient rehabilitation hospital.

Covenant Health (Knoxville, Tenn.).
Covenant Health employs approximately 10,000 people and has more than 1,000 affiliated physicians who serve at eight hospitals in addition to outpatient centers and other facilities. Covenant Health operates the Fort Sanders Nursing Department, a baccalaureate nursing education program at Tennessee Wesleyan College, located in Athens. It also offers health screenings and other educational opportunities through its Center for Community Health. In addition, the system has a physician practice management company, Covenant Medical Management, which supports approximately 90 physicians in 40 medical practices.

CoxHealth (Springfield, Mo.).
As of fiscal year 2010, CoxHealth had nearly 8,800 employees and 500 physicians on staff. The health system provides care in three hospitals, more than 60 physician clinics and numerous urgent care facilities and other outpatient sites. CoxHealth offers several educational opportunities, including Cox College, Cox Family Medicine Residency, PGY-1 Pharmacy Residency and the School of Medical Technology. The health system also includes Cox HealthPlans, which offers individual, HMO and PPO plans.

Fairview Health Services (Minneapolis). Fairview Health Services has 22,000 employees, 2,500 affiliated physicians, more than 40 primary care clinics, 10 hospitals and a variety of other care facilities. The system partners with the University of Minnesota and owns the University of Minnesota Medical Center, Fairview and the University of Minnesota Amplatz Children's Hospital. Fairview also has 700 affiliated academic physicians in the group practice University of Minnesota Physicians and a network of 630 independent physicians in Fairview Physician Associates. In November, the system acquired Bloomington Lake Clinic, which has locations in Minneapolis and Bloomington, Minn.

Franciscan Health System (Tacoma, Wash.). Franciscan Health System, part of Englewood, Colo.-based Catholic Health Initiatives, includes five hospitals and multiple surgery centers, medical clinics and centers for advanced medicine. The system employs 8,100 people and has approximately 1,400 medical staff members. In addition, Franciscan Health System includes the Franciscan Medical Group, the largest physician-led, multi-specialty group in the South Puget Sound area. The system's St. Clare Hospital in Lakewood plans to begin a $15.5 million renovation project in early 2012.

Geisinger Health System (Danville, Pa.). Physician-led Geisinger Health System includes 37 community practice sites and numerous hospitals, outpatient centers and other care facilities. Geisinger employs roughly 14,400 people, including 880 physicians/scientists and 470 advanced practitioners. The health system offers multiple health plans and owns a technology company called ISS Solutions, which provides technology lifecycle management solutions to a variety of industries. In September, Geisinger partnered with Schuylkill Health System in Pottsville, Pa., to create a cancer treatment facility on the Schuylkill Medical Center campus.

Genesis Health System (Davenport, Iowa). Genesis Health System includes four hospitals, numerous medical centers and clinics, a home equipment store and First Med Pharmacy, among other resources. The system has more than 600 physicians and 5,000 staff members and operates Genesis Health Group, a network of physicians. In November, Genesis Health System announced plans to build an approximately 45,000-square-foot medical park, including a medical office building, at an estimated cost of $10 million.

Gundersen Lutheran Healthcare (La Crosse, Wis.).
Physician-led Gundersen Lutheran Healthcare consists of three affiliated hospitals, four affiliated nursing homes, 23 medical clinics, three podiatry clinics, eight behavioral health clinics, 12 eye clinics and two sports medicine clinics. The system includes more than 700 medical, dental and associate staff and a support staff of more than 5,500. The Gundersen Lutheran Health Plan offers several health insurance options, including HMO plans, point of service plans and a Medicare plan. Gundersen Lutheran Healthcare, which is the designated Western Clinical Campus for the University of Wisconsin School of Medicine & Public Health and School of Nursing, also features an environmental program called Envision to lower costs and improve the environment.

HCA Midwest Health System (Kansas City, Mo.).
HCA Midwest Health System, the largest healthcare network in the greater Kansas City area, has more than 8,000 employees and 1,500 physicians. Its physician network, Midwest Physicians, includes 230 physicians at 58 practices in 77 locations. The system, part of Nashville, Tenn.-based HCA, is comprised of nine hospitals, six surgery centers and one psychiatric care facility. In late summer, HCA Midwest's Research Belton (Mo.) Hospital broke ground on an 82,000-square-foot, $39.1 million expansion and renovation project, which will include a new emergency department, surgery department and medical office building as well as updated patient rooms and support offices.

Health First (Rockledge, Fla.). Health First includes four hospitals, one of which — Viera (Fla.) Hospital — was added in April. The health system has the largest multi-specialty physician group in central Brevard, Fla., and Health First is also Brevard's largest commercial health insurer. Health First Health Plans offers Medicare Advantage, commercial point of service plans and commercial HMO plans. In April, Health First formed a partnership with Jacksonville, Fla.-based Nemours to expand its pediatric care.

Henry Ford Health System (Detroit). Henry Ford Health System, which is affiliated with Wayne State University's School of Medicine, consists of six hospitals, 29 medical centers, 20 pharmacy locations and several medical centers. HFHS includes the Henry Ford Medical Group, one of the country's largest group practices with more than 1,200 physicians. Employing more than 23,000 people, the health system is the fifth-largest employer in metro Detroit. HFHS also offers PPO, HMO, Value and Medicare insurance plans via the Health Alliance Plan, medical supplies through its Henry Ford Health Products and eye care through a partnership between Henry Ford OptimEyes and Eye Care Services.  


Inova Health System (Falls Church, Va.). Six-hospital Inova Health System has more than 16,000 employees, including more than 150 physicians in the Inova Medical Group. The health system is engaged in several community initiatives, including Partnership for Healthier Kids, a collaboration of 100 schools and a dozen business and government organizations that provide affordable care for medically underserved children. Inova's Health Information Partnership is a program with Fairfax County Public Library, established to improve community access to health information.

Intermountain Healthcare (Salt Lake City).
Intermountain Healthcare has 23 hospitals, 165 clinics and a variety of other medical facilities. The health system has more than 32,000 employees and more than 800 physicians and caregivers in its Intermountain Medical Group. In addition, Intermountain offers health insurance through SelectHealth, which includes individual, employer and federal employee plans. In February, the health system opened the Intermountain Homer Warner Center for Informatics Research, which centralized 60 full-time health IT positions.

Jackson Health System (Miami). With more than 12,000 employees, Miami-Dade County-owned Jackson Health System serves patients at six hospitals, four primary care centers, 17 school-based clinics and numerous other access sites. The system, which is affiliated with the University of Miami Leonard M. Miller School of Medicine and Florida International University Herbert Wertheim College of Medicine, also has the county's only Level 1 adult and pediatric trauma center and the only burn center in south Florida. In addition to direct care, Jackson offers the JMH Health Plan, an HMO.

Kaiser Permanente (Oakland, Calif.). Kaiser Permanente is comprised of Kaiser Foundation Hospitals and their subsidiaries, Kaiser Foundation Health Plan and The Permanente Medical Groups, a physician-owned and operated practice. As of 2010, Kaiser had 36 hospitals; 533 medical offices; and roughly 15,800 physicians and 167,000 employees. The system has been a pioneer in electronic health records, and its KP HealthConnect is the largest private EHR in the world. Kaiser also won the HIMSS Organization Davies Award in 2011 for its implementation and use of health IT.

Legacy Health System (Portland, Ore.). Legacy Health System, the largest non-profit, community-owned health system in the Portland/Vancouver area, includes six hospitals and more than 50 medical clinics, among other facilities. It employs more than 9,500 people and has approximately 2,500 physicians on medical staff. Legacy Medical Group consists of more than 300 physicians and other providers, including nearly 100 hospitalists. In 2007, Legacy Health System began transforming its primary care clinics into patient-centered medical homes and is continuing to promote this new model of care.

Lehigh Valley Health Network (Allentown, Pa.).
Lehigh Valley Health Network cares for patients in three hospitals, 40 primary and specialty clinics, retail health clinics through a partnership with Geisinger Health System and numerous other facilities. It has 9,500 employees and 1,100 primary care and specialty physicians, 400 of whom are employed. LVHN also offers Health Spectrum Pharmacy Services at three locations and Valley Preferred — a PPO. In March, LVHN began a telemedicine partnership with Blue Mountain Health System in Palmerton and Lehighton, Pa., and in April it partnered with Phoebe Ministries in Allentown, Pa., for teleneurology.

McLaren Health Care (Flint, Mich.). McLaren Health Care has nearly 150 facilities, including nine hospitals and more than 100 primary and specialty centers. The health system employs 15,000 people — 50 of which are primary care physicians and specialists in the McLaren Medical Group — and has more than 10,000 network physicians. McLaren Health Care also offers the McLaren Health Plan, which includes commercial and Medicaid HMOs; a medical malpractice insurance company; and nearly 500 residency and fellowship positions.

MedStar Health (Columbia, Md.). MedStar Health consists of nine hospitals and 20 other health-related businesses. The system includes MedStar Physician Partners, a network of more than 100 physicians; MedStar Family Choice, a managed care organization; and MedStar Pharmacy, among other services. With more than 26,000 associates and 5,300 affiliated physicians, it is one of the largest employers and one of the largest health systems in the Maryland and Washington, D.C., region. MedStar Health also features MedStar Partners, a program through which the health system develops business relationships with diverse local businesses.

Memorial Hermann Healthcare System (Houston). Memorial Hermann Healthcare System is the largest non-profit healthcare system in Texas, with 11 hospitals, 10 surgery centers, 27 sports medicine and rehabilitation centers, 12 diagnostic laboratories, 21 imaging centers and more. The system employs nearly 20,000 people, has more than 4,000 medical staff members and more than 3,500 independent physicians in its Memorial Hermann Health Network Providers. In addition, Memorial Hermann-Texas Medical Center is the teaching hospital for The University of Texas Medical School at Houston.

Mercy (St. Louis). In Sept. 2011, networks of care including St John's Mercy Health Care began a brand change to "Mercy" to more clearly reflect the integration of its facilities. Mercy has more than 400 clinic and hospital locations across seven states, employs 38,000 people and has 1,500 physicians. Mercy Clinic includes thousands of physicians and teams across the Mercy system. In October, Mercy announced plans to build the nation's first virtual care center — a $90 million facility that would consolidate Mercy's existing telemedicine programs and new telehealth projects. The center, which is expected to open in two-and-a-half years, is estimated to cost $90 million with an additional investment of $590 million in technology.

Mercy Health System (Janesville, Wis.). Mercy Health System features 64 facilities, including three hospitals and multiple specialty centers and clinics. The system has proposed a $115 million, 70-bed hospital in Crystal Lake, Ill., which would extend its geographic reach. Mercy Health System employs nearly 4,000 people, 285 of whom are physicians. It offers several insurance products, including an HMO, Medicare supplement and Medicaid HMO.

Methodist Healthcare (Memphis, Tenn.). Methodist Healthcare is comprised of seven hospitals and multiple home health agencies and outpatient clinics. It has 10,000 employees, 2,000 physician partners and teaching partnerships with the University of Tennessee and the University of Memphis. The health system also includes Health Choice, a joint venture with MetroCare Physicians, which is the exclusive managed care contracting organization for Methodist Healthcare. In October, Methodist Healthcare partnered with The West Clinic to offer integrated cancer services, and in the process gained 110 West Clinic employees as Methodist Healthcare associates.

MultiCare (Tacoma, Wash.). With more than 9,300 employees, including 327 physicians, MultiCare is the largest private employer in Pierce County. It also employs more than 1,000 physician specialists. The system has more than 93 sites of care, including four hospitals, 16 primary clinics and many outpatient centers and clinics. MultiCare also includes MultiCare Consulting Services, a company providing revenue cycle strategy for healthcare providers. In October, MultiCare became one of the first systems in Washington to meet meaningful use through the implementation of its electronic health record system, MultiCare Connect.

North Shore-Long Island Jewish Health System (Great Neck, N.Y.). Fifteen-hospital North Shore-Long Island Jewish Health System is the country's second-largest non-profit secular healthcare system, based on number of beds. Its Center for Learning and Innovation is the healthcare industry's largest "corporate university" and its Patient Safety Institute is the country's largest patient simulation center. With more than 43,000 employees, the health system is the largest employer on Long Island. North Shore-LIJ Health System also has more than 9,000 physicians and nursing school affiliations with 15 colleges and universities.

NorthShore University HealthSystem (Evanston, Ill.). NorthShore University HealthSystem has approximately 9,000 employees and 2,400 affiliated physicians, including more than 700 physicians in the NorthShore Medical Group. The health system is also the principal teaching affiliate for the University of Chicago Pritzker School of Medicine. In 2003, NorthShore was among the first in the United States to successfully launch a system-wide electronic medical record, which is called NorthShoreConnect.

Northwestern Memorial HealthCare (Chicago). Northwestern Memorial HealthCare includes two hospitals, a physician group, an insurance company and a managed care contractor. Its Northwestern Memorial Hospital employs more than 7,000 people, has approximately 1,600 affiliated physicians and is the primary teaching hospital for Northwestern University's Feinberg School of Medicine. In December, the hospital announced that its proposed outpatient care pavilion could create more than 650 new permanent positions. The system's Northwestern Lake Forest Hospital includes 1,862 employees and 600 physicians; Northwestern Memorial Physicians Group consists of 97 physicians in 15 medical offices.

Novant Health (Winston-Salem, N.C.). Novant Health includes 13 hospitals and a medical group with 1,117 physicians in 360 clinic locations across North Carolina, Virginia, South Carolina and Georgia, in addition to other care facilities. It also offers Novant Health Shared Services, a company that partners with hospitals to improve operations and finances. In November, Novant Health partnered with MedStar Health and Sentara Healthcare to create MNS Supply Chain Network, designed to reduce the health systems' supply expenses and improve efficiency.

OSF HealthCare (Peoria, Ill.). OSF HealthCare has more than 12,000 employees and includes OSF Healthcare System, OSF Medical Group, OSF Home Care Services and other entities. OSF Healthcare System consists of seven hospitals and medical centers, one long-term care facility and two colleges of nursing. OSF Medical Group includes more than 600 employed physicians and other providers at more than 50 office sites and eight LLC corporations. OSF Healthcare System has also developed relationships with community hospitals, called Independent Affiliates, to collaborate on care while maintaining each organization's independence and governance.

Presbyterian Healthcare Services (Albuquerque, N.M.). Presbyterian Healthcare Services includes eight hospitals, a health plan and Presbyterian Medical Group. The medical group has more than 500 employed physicians and practitioners at 30 different locations and is the fastest growing medical group in the state. The health system is a pioneer in the state in other ways as well, serving as the only private, non-profit healthcare system, the largest provider of healthcare and the largest managed care organization in New Mexico.

ProMedica Health System (Toledo, Ohio). ProMedica Health System consists of 306 facilities, including 11 member and affiliate hospitals. The health system has more than 14,000 employees and approximately 1,650 physicians, including more than 315 physicians in its medical practice, ProMedica Physicians. The health system also offers Paramount, a regional maintenance organization in northwest Ohio, and the Academic Health Center, an academic collaboration with The University of Toledo.

Providence Health & Services (Renton, Wash.). Providence Health & Services has 27 hospitals, 214 physician clinics, 22 assisted living and long-term facilities and 13 hospice and home health agencies. Spanning five states — Alaska, California, Montana, Oregon and Washington — Providence Health & Services employs nearly 53,000 people, including 1,358 employed physicians. In October, Providence formed an innovative partnership with Seattle-based Swedish Health Services in which both organizations collaborate on healthcare services while retaining their individual identities.

Roper St. Francis Healthcare (Charleston, S.C.). Roper St. Francis Healthcare has 90 facilities and physician offices, including four hospitals with plans to build another. The health system has nearly 800 physicians and employs more than 5,100 people, making it Charleston's largest non-governmental, private employer. The system also includes Physician Partners, a network of more than 180 physicians, and Wellness Partners, which provides care to businesses' employees.


Saint Francis Health System (Tulsa, Okla.). Saint Francis Health System has approximately 7,000 employees and nearly 1,000 physicians. It consists of five hospitals in addition to other outpatient centers and pharmacies. The health system also includes Warren Clinic, the largest privately-owned physician group in Oklahoma, with more than 210 physicians at more than 40 locations.

Sanford Health System (Fargo, N.D., Sioux Falls, S.D.). Sanford Health is the largest rural non-profit healthcare system in the nation, spanning eight states with international clinics underway in Belize and Ireland. The system's care sites include 31 hospitals, 111 clinics and 31 long-term care facilities. The system employs 18,000 people, making it the largest employer in North and South Dakota, and has more than 900 physicians. In addition, Sanford offers a physician-led, non-profit health plan.

Scripps Health (San Diego). Scripps Health includes four acute-care hospitals, more than 20 primary and specialty care outpatient centers and a variety of other facilities. The system has more than 2,600 affiliated physicians and 13,000 employees, and Scripps Clinic includes more than 400 physicians. Scripps Health is affiliated with several medical groups including Mercy Physicians Medical Group, Scripps Mercy Physician Partners, XiMED Medical Group and Connect the Docs.

Sentara Healthcare (Norfolk, Va.). Sentara Healthcare has more than 100 care sites, including 10 acute-care hospitals, six outpatient care campuses, seven nursing centers, three assisted living centers and seven advanced imaging centers. Sentara has approximately 3,400 medical staff members in addition to roughly 380 physicians in Sentara Medical Group. The health system founded Optima Health, the region's first managed-care plan, in 1984. In 2000, Sentara Healthcare became the first in the country to develop the eICU, a remote monitoring system for intensive care.

Sharp HealthCare (San Diego). Sharp HealthCare employs 14,000 people at its four acute-care hospitals, three specialty hospitals, 10 pharmacies and numerous other health facilities. The health system is affiliated with Sharp Rees-Stealy and Sharp Community Medical Group and includes 2,600 physicians. Sharp Health Plan, the only San Diego-based commercial health plan, offers health plans for employers of all sizes

St. John's Health System (Springfield, Mo.).
Six-hospital St. John's Health System, a member of the Sisters of Mercy Health System-St. Louis, has more than 10,000 employees. Physician-led St. John's Clinic is the region's largest multispecialty physician group with more than 470 physicians and 220 mid-level and allied health practitioners in more than 70 offices. St. John's also offers St. John's Health Plans, the largest managed care provider in the region, and corporate heath and wellness programs.

Sutter Health (Sacramento, Calif.). Sutter Health includes more than 20 hospitals, 20 ambulatory surgery centers and numerous outpatient facilities. The system has roughly 47,000 employees and 5,000 affiliated physicians. Sutter is affiliated with several educational institutions, including Samuel Merritt University and California Pacific Medical Center Graduate Medical Education. In May, Sutter opened its new $630 million, 241-bed Mills-Peninsula Medical Center in Burlingame, Calif.

TriHealth (Cincinnati). TriHealth has two hospitals, three ambulatory centers and more than 50 other locations. In November, the system finalized an agreement to purchase the Butler County Medical Center, which it will consolidate into TriHealth's Bethesda North Hospital in March. TriHealth is the region's fifth largest employer with approximately 10,000 employees and has more than 200 primary care and specialist physicians within affiliated physician groups. TriHealth is affiliated with the University of Cincinnati College of Medicine, and Good Samaritan College of Nursing and Health Science is a subsidiary of TriHealth and TriHealth's Good Samaritan Hospital, also in Cincinnati.

University Hospitals (Cleveland). University Hospitals is a network of primary care physicians, outpatient centers and hospitals. The system includes more than 24,000 physicians and employees in its facilities and its partner hospitals, making University Hospitals the second largest private sector employer in Northeast Ohio. University Hospitals Case Medical Center is an affiliate of Case Western Reserve University. In addition, on Jan. 1, 2011 University Hospitals formed the UH Accountable Care Organization.

University of Pittsburgh Medical Center. UPMC has three major operating units: provider services, including more than 400 clinical locations; insurance services; and international and commercial services. With more than 54,000 employees, UPMC is western Pennsylvania's largest employer. The system has nearly 5,000 affiliated physicians, 3,000 of which UPMC employs. UPMC is also closely affiliated with the University of Pittsburgh and has more than 1,400 medical residents and clinical fellows. In October, UPMC announced it will invest nearly $300 million to create a research facility called the Center for Innovative Science.

WellSpan Health (York, Pa.).
WellSpan has more than 40 locations and includes two hospitals, six retail pharmacies, 10 outpatient health centers and 47 physician practices. The system, which has 8,000 physicians, employees, volunteers, board members and auxilians, also includes VNA Home Health and WellSpan Pharmacy. In November, WellSpan Rehabilitation agreed to purchase the operating assets of Wilderman & Associates Physical Therapy.

WellStar Health System (Marietta, Ga.). WellStar Health System includes five hospitals, five urgent care centers, 14 satellite diagnostic imaging centers and more than 100 physician practice locations. In addition to the system's more than 12,000 employees and 1,126 medical staff members, the WellStar Medical Group has more than 500 primary care providers, specialists and advanced practitioners. In November, WellStar signed a letter of intent to acquire OrthoSport Physical Therapy.

Wheaton Franciscan Healthcare-SE Wisconsin (Glendale). Wheaton Franciscan Healthcare in southeast Wisconsin is the second largest private employer in the state, with nearly 11,000 associates and affiliations with more than 1,300 physicians. The system includes six acute-care hospitals, two outpatient centers, three transitional and extended care facilities and one home health and hospice agency. In addition, Wheaton Franciscan Medical Group has more than 350 physicians at nearly 50 locations.

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