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The two deals
Sanford Health, the Sioux Falls-based system with 58 hospitals, signed a definitive agreement on May 8 to combine with Robbinsdale, Minn.-based North Memorial Health, which runs two hospitals and more than 22 clinics in the Twin Cities. The combined system would stay nonprofit, with Sanford CEO Bill Gassen leading it and North Memorial CEO Trevor Sawallish heading a Twin Cities region of about 6,800 employees. The partners pledge $600 million to modernize Robbinsdale Hospital, one of Minnesota’s five level 1 trauma centers, and roughly double the size of Maple Grove Hospital. Sanford had tried to enter the Twin Cities through Fairview in 2013 and 2022.
Earlier in the week, UPMC agreed to acquire Steubenville, Ohio-based Trinity Health System from CommonSpirit, its first move into Ohio. Terms were not disclosed, and the parties hope to close in the fall pending regulatory approval. UPMC reported $35 billion in fiscal 2025 revenue, and Fitch moved its outlook to stable in March.
What the pattern says
Kaufman Hall counted 22 announced hospital deals in the first quarter, the most for a first quarter since 2020, and 15 of them were divestitures. CommonSpirit is a clear example. Beyond Trinity, it is exploring a sale of three North Dakota hospitals to Altru and selling its Conifer stake back to Tenet. Large systems are shedding facilities outside their core markets, and well-capitalized buyers are using them to build adjacent regions.
The Sanford deal also lands in a state where Sutter Health and Allina Health are working toward a 39-hospital combination with about $26 billion in revenue. Minnesota Attorney General Keith Ellison is reviewing the Sanford transaction under the state’s health care transaction, antitrust and charities laws, including whether it serves the public interest. SEIU Healthcare Minnesota & Iowa and the Minnesota Nurses Association have asked for enforceable commitments on staffing, contracts and access.
Questions for boards
- If you are a seller, which facilities does your system no longer see as core, and who in the region could run them better?
- If you are a buyer, are your capital commitments specific enough to satisfy a public-interest review?
- How will labor commitments be written, and who will monitor them after closing?
- What does a cross-market partner add in payer leverage, recruiting and access to capital that a local affiliation cannot?
Archive entry for May 12, 2026, added Nov. 11, 2026.
Sources
- Sanford, North Memorial planned combination adds to Minnesota healthcare deal wave (Becker’s Hospital Review, May 8, 2026)
- Sanford Health, North Memorial Health agree to combine (FOX 9, May 8, 2026)
- UPMC reaches deal to acquire Ohio hospitals from CommonSpirit Health (Chief Healthcare Executive, May 7, 2026)