SIOUX FALLS, S.D. — Sanford Health and UnityPoint Health, an Iowa-based health system, have announced that they're exploring joining to form what would rank among the nation's 15 largest nonprofit health systems, with more than $11 billion in revenue.

The announcement, made Friday, June 28, discloses that the two health systems have signed a letter of intent "to explore joining their trusted brands as they seek to become the destination for personalized primary care in America's Heartland."

The decision follows "considerable exploration between the leadership teams from each organization," the joint statement said.

"Sanford and UnityPoint are two successful systems intent on controlling our own destiny," Kelby Krabbenhoft, president and CEO of Sanford Health, said in the statement. "We believe that in the very near future, fully integrated health systems will drive greater value through affordable options for high-quality health care to patients, governments and employers."

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Working together, Sanford and UnityPoint will "better meet this need," Krabbenhoft added, "creating a new system positioned for continued growth across a broad geography."

Kevin Vermeer, president and CEO of UnityPoint, said the organizations "share a deep commitment: to patient care and a vision for transforming and sustaining health care in the communities they serve.

"We are approaching our discussions very purposefully, with a clear and common vision for success," he said. "First and foremost, our focus is on people. Working together, we will find new ways to broaden access to care — beyond traditional settings — and take greater responsibility for the health of the populations we serve."

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The combined organization would employ more than 83,000 staff and 2,600 physicians, with operations in 26 states and nine countries, including hospitals, clinics, health plans and networks, post-acute care, research and innovation.

Although talks are ongoing, the two organizations have agreed on "certain principles that will guide their work" as discussions continue over the next few months:

Krabbenhoft would serve as the CEO of the new organization, while Vermeer would be senior executive vice president.

The organizations would have a united governing board, a new board made up of representatives from both organizations, and UnityPoint would recommend the first chairperson. The board also would have unaffiliated members with "relevant national industry experience and expertise."

Both organizations would continue to operate their respective fully-integrated medical groups and "maintain longstanding relationships with independent physicians, hospitals and other health care partners.

The transaction is subject to regulatory reviews. "Timelines are still fluid, but leaders intend for the transaction to be completed, pending regulatory reviews, by the end of 2019," the joint statement said.

Sanford, headquartered in Sioux Falls, has 1,400 physicians, 44 hospitals and more than 200 Good Samaritan Society senior care locations in 26 states and nine countries. It provides integrated health services in an area including North Dakota, South Dakota, Minnesota and Iowa. UnityPoint has relationships with more than 280 physician clinics, 32 hospitals, serving Iowa, western Illinois and southern Wisconsin.

Sanford reports revenues of $7.5 billion, while UnityPoint has revenues of about $4.4 billion.