Top health system mergers, acquisitions, and affiliations

In a move that will reshape the healthcare landscape in Missouri, St. Louis’ largest health system, BJC HealthCare, and Kansas City’s second-largest, Saint Luke’s Health System, will join forces. This merger, which brings together 28 hospitals across the state, is just one of the latest in the ongoing consolidation of the hospital industry.

How many healthcare mergers and acquisitions occurred in 2023?

In 2023 so far, Definitive Healthcare tracked more than 200 articles on mergers and acquisitions (M&As), reflecting the strategic realignment and consolidation within the healthcare sector. Collectively, the top 10 health systems now manage over 1,400 hospitals, or 18% of all hospitals managed by health systems. The top health systems also manage more than 186 million hospital beds, or 18% of all health system beds, and account for about one in five discharges. Below are the top 10 health systems by number of staffed hospital beds.

Top 10 health systems by number of staffed hospital beds

Fig. 1 - Data is from the Definitive Healthcare HospitalView product, according to the most recent 12-month interval tracked in our database. Data is sourced from the October 2023 Medicare Cost Report release. Accessed December 2023.

What were the biggest healthcare mergers and acquisitions in 2023?

Health systems may opt to merge for various strategic, financial, and operational reasons. Notable health system mergers and merger announcements this year include the following:

• CommonSpirit completed its acquisition of five hospitals in Utah and more than 25 medical group clinics, including a clinically integrated network, from Steward Health Care.
• Kaiser Permanente agreed to acquire Geisinger Health in a deal that will make the Pennsylvania-based health system the first to join Risant Health, a new nonprofit organization.
• St. Louis-based BJC HealthCare and St. Luke’s Health System, based in Kansas City, finalized plans to merge in a deal that will form a 28-hospital, $10 billion academic health system in Missouri.
• Two Wisconsin health systems, Froedtert Health and ThedaCare, have signed a letter of intent to combine into a single, 18-hospital system.
• The University of Michigan Health acquired Sparrow Health System to become a $7 billion health system with more than 200 care sites across Michigan.

We also saw at least one big deal fall apart this year: New Mexico-based Presbyterian Healthcare Services and Iowa-based UnityPoint Health called off a cross-market merger that would have resulted in an $11 billion entity with almost 50 hospitals.

Beyond hospitals, health systems are also snapping up ambulatory surgery centers (ASCs), urgent care clinics, and other sites of care as more care continues to shift from inpatient to outpatient settings. Below, we highlight the top 10 health systems by number of affiliations.

Top 10 health systems by number of affiliations