Some of the largest health system mergers and acquisitions over the two years have been cross-market transactions, a trend that is anticipated to gather momentum despite the Federal Trade Commission taking a firmer stance on deals that could potentially violate antitrust laws.

The CEO of Derby, Conn.-based Griffin Hospital warned Gov. Ned Lamont that the debt burden of the hospital's parent company, Prospect Medical Holdings, and a recent cyberattack could complicate a potential sale to Yale New Haven Health, CT Mirror reported Sept. 21.

El Segundo, Calif.-based Pipeline Health has agreed a deal to sell White Rock Medical Center in Dallas to Heights Healthcare of Texas. The sale is expected to close on or before Oct. 2.

Children's Hospital of Philadelphia and Allentown, Pa.-based Lehigh Valley Health Network have inked an affiliation agreement to expand on their long-standing relationship. 

Dallas-based Medical City Healthcare is edging closer to taking over Decatur, Texas-based Wise Health system, with the transaction due to close in the fourth quarter.

The takeover of Burgaw, N.C.-based Pender Medical Center by Novant Health, which plans to turn the facility into a community hospital, took a step forward when county commissioners voted unanimously to approve the transaction, according to a Sept. 18 report from NBC affiliate WECT6 News.

CommonSpirit Health and AdventHealth decided to disaffiliate in February, breaking up their joint venture Centura Health.

St. Louis-based Mercy has finalized a lease agreement to operate and manage the county-owned Perry County Memorial Hospital in Perryville, Mo., effective Oct. 1. 

The American Hospital Association has penned a 23-page letter asking the Federal Trade Commission and Justice Department not to finalize proposed adjustments to their merger guidelines. 

UF Health, the University of Florida's academic health center in Gainesville, has completed the acquisition of St. Augustine, Fla.-based Flagler Health+, which will be renamed UF Health St. Johns.

Terre Haute, Ind.-based Union Health will acquire Terre Haute Regional Hospital, which is part of Nashville, Tenn.-based HCA Healthcare.

Two Wisconsin community hospitals about 60 miles apart have joined forces to create a new system: Tamarack Health. 

Mercy Iowa City hospital, which is the subject of a takeover by the University of Iowa health system, may not remain as a hospital as bondholders seek to solicit other competitive bids from the likes of developers, according to a Sept. 12 The Gazette report.

Southern states such as Mississippi, North Carolina, South Carolina, Tennessee, Texas and Virginia have enacted laws that are paving the way for large hospital mergers, despite research indicating that lack of competition often leads to fewer services at higher costs, NC Newsline reported Sept. 7. 

Franklin, Tenn.-based Community Health Systems, one of the largest for-profit health systems in the country, is expanding its treatment options for behavioral health patients by integrating services into a primary care setting.

Milwaukee-based Froedtert and Neenah-based ThedaCare, two Wisconsin health systems, have signed a definitive agreement to merge into an 18-hospital system. 

The American Hospital Association wants the Federal Trade Commission to pull its proposed changes to premerger notifications under the Hart-Scott-Rodino Act, which requires organizations to report large transactions to the FTC and Justice Department for antitrust review.

Here is a summary of hospital and healthcare merger and acquisition-related transactions from August:

Billings (Mont.) Clinic and Kalispell, Mont.-based Logan Health officially merged Sept. 1, with attention now turning to implementing a cohesive integration plan, according to the Daily Inter Lake.

Financially challenged Doylestown (Pa.) Health has finalized the sale of its Pine Run retirement community, selling it to Presbyterian Senior Living for $80.6 million.