Hospital consolidation continues to gather momentum across the country, with one state in particular, Pennsylvania, seeing more merger and acquisition activity than any other.

The University of Texas System plans to merge UT Health San Antonio and the University of Texas at San Antonio to form a unified institution in 2025. 

Since July 31, three of the largest publicly traded for-profit health systems reached agreements to sell hospitals: 

Rural and community hospitals and smaller health systems are struggling to push their operating margins back into the black, with many continuing to seek strategic partners or acquisitions to ensure access to care. Academic health systems are stepping up.

Houston Healthcare, a community-based, nonprofit health system in Warner Robins, Ga., and Emory Healthcare, an 11-hospital academic health system in Atlanta, have signed a letter of intent for Houston Healthcare to join Emory Healthcare, according to an Aug. 22 news release.

The County of Santa Clara, Calif., has reached a tentative agreement with Nashville, Tenn.-based HCA Healthcare to purchase its San Jose, Calif.-based Regional Medical Center for $175 million, allowing the hospital to integrate with the county operated Santa Clara Valley Healthcare system.

Altamonte Springs, Fla.-based AdventHealth, a health system with more than 50 hospitals in nine states, plans to assume management of St. Luke's Hospital in Columbus, N.C.

Statesville, N.C.-based Iredell Health System has signed a definitive agreement to buy Davis Regional Psychiatric Hospital from Franklin, Tenn.-based Community Health Systems in a deal that is expected to close this fall. News of the acquisition comes after Novant Health called off plans to acquire the facility in June. 

From Prime Healthcare signing a deal to acquire nine hospitals from Ascension to Kaiser's Risant Health making a deal to acquire a second system, here are 10 health system mergers and acquisitions to know that have been announced or completed in 2024. 

Philadelphia-based University of Pennsylvania Health System and Doylestown (Pa.) Health signed a definitive agreement for Doylestown to become part of Penn Medicine. 

Dallas-based Steward Health Care and Orlando (Fla.) Health have entered into a binding asset purchase agreement for Steward's northern Florida assets for $439.42 million in cash, according to Aug. 14 bankruptcy court documents obtained by Becker's. 

Gravette, Ark.-based Ozarks Community Hospital has acquired Decatur (Ark.) Medi Clinic and renamed it OCH Decatur Clinic.

Merger and acquisition activity is picking up steam this year after a decline in deal volume during the pandemic, with some large health systems reorganizing their portfolios and offloading hospitals in various markets. 

Dallas-based Steward Health Care has entered into a definitive agreement to sell its physician group, Stewardship Health, to Nashville, Tenn.-based Rural Healthcare Group, part of private equity firm Kinderhook Industries, for $245 million in cash, according to an Aug. 12 bankruptcy court filing, obtained by Becker's. 

Charleston, S.C.-based Roper St. Francis Healthcare has shared plans to sell Charleston-based Roper Hospital to the Medical University Hospital Authority, a component of the Medical University of South Carolina, according to an Aug. 10 news release.

Merger and acquisition activity is rebounding after a drop in deal volume during the pandemic, with many large health systems growing their hospital portfolios or planning to add more hospitals in the coming quarters.

Los Angeles-based Prospect Medical Holdings and CHA Partners have signed a letter of intent for CHA to acquire Upland, Pa.-based Crozer Health, a spokesperson for the system confirmed to Becker's.

Novant Health is looking to acquire a 200-provider urgent care group from Blue Cross and Blue Shield of South Carolina.

Dallas-based Tenet Healthcare has agreed to sell its 70% majority ownership interest in Birmingham, Ala.-based Brookwood Baptist Health to Orlando (Fla.) Health.

There were 5 mergers and acquisitions completed Aug. 1 that affected 40 hospitals, including one deal that created one of the largest nonprofit systems in the U.S.