As some of the country’s largest health systems exit markets, others are moving in. From Nevada to Ohio to Pennsylvania, systems are planting flags in new states in 2026.
Cross-market deals have become an increasingly prominent vehicle for that strategy, carrying less antitrust risk than same-market combinations and offering the payer leverage a larger geographic footprint provides.
One example is Oakland, Calif.-based Kaiser Permanente, which entered Nevada in February as it finalized a joint venture with Reno, Nev.-based Renown Health to launch a new outpatient care delivery system and jointly own health plan Hometown Health.
The joint venture was announced in September when Renown Health President and CEO Brian Erling, MD, said that 40% of new residents in Nevada have moved from California, and many of them are former Kaiser Permanente members.
Pittsburgh-based UPMC is planning to enter Ohio through a definitive agreement with Chicago-based CommonSpirit Health to transfer ownership of Steubenville, Ohio-based Trinity Health System. The system includes multiple hospital facilities and clinics, with the deal expected to close in the fall. It comes as CommonSpirit continues to divest hospitals amid industry headwinds — a dynamic playing out across the industry as systems rationalize portfolios and exit markets where others see opportunity.
Some systems are entering new states with smaller facilities first. In January, New Hyde Park, N.Y.-based Northwell Health began welcoming patients to its first Pennsylvania location, a primary and immediate care center in Dingmans Ferry. Northwell said a second location is expected to open in Hawley, Pa., in summer 2026.
The expansion follows a year of significant growth for Northwell, which merged with Danbury, Conn.-based Nuvance Health in 2025 and formed a 28-hospital system reaching from New York City to western Connecticut.
On a more local scale, Ann & Robert H. Lurie Children’s Hospital of Chicago proposed a new pediatric hospital in Downers Grove, Ill., which would be its first inpatient hospital outside of Chicago. The hospital would fill a care access gap in Chicago’s western suburbs, where nearly half of children leave their community for inpatient pediatric care, President and CEO Tom Shanley, MD, told Becker’s, adding that the expansion responds to a broader trend of pediatric unit closures nationwide.
The new market entrances follow years of cross-market mergers that have become more common. One example is Sacramento, Calif.-based Sutter Health and Minneapolis-based Allina Health, which signed a letter of intent in March for Allina to join the system and create a combined 39-hospital system. It would mean Sutter’s entrance into the Midwest; Sutter currently operates hospitals in California. Sutter Health CEO Warner Thomas told Becker’s that the transaction would bring together Allina’s clinical capabilities with Sutter’s investments in ambulatory care and digital infrastructure.
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