South Dakota-based Sanford Health and North Dakota-based MeritCare Health System have merged to become one of the country’s largest integrated health care systems—Sanford Health-MeritCare.

The new system will prioritize the development of new services in centers of excellence such as heart, cancer, women’s, children’s, emergency, trauma, and orthopedic health. Additionally, the new system will expand education and medical training programs opportunities for staff.

The new organization is now the largest, not-for-profit rural health care provider in the nation. The new Sanford and MeritCare organization encompasses six states: North Dakota, South Dakota, Minnesota, Iowa, Nebraska, and Oklahoma with 17,400 employees and 29 hospitals, serving over 2 million people in the service area.