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Carolinas HealthCare System's flagship hospital in Charlotte, N.C. (Carolinas HealthCare)

Carolinas HealthCare System and UNC Health Care are planning to merge by the middle of next year, the two hospital systems said Thursday. The combined not-for-profit giant would own a medical school as well as numerous hospitals, clinics, outpatient centers and other facilities throughout North Carolina and South Carolina.

Why it matters: This is the biggest proposed not-for-profit hospital system merger so far this year, creating a regional behemoth with $14 billion of revenue that could exert large pricing power over health insurers. The UNC-Carolinas system would be one of the 15 largest health systems in the country by revenue — another step in the hospital industry's movement toward building up massive scale within a cluster of states.

Yes, but: There's no guarantee it will pass antitrust review.

More details: Gene Woods, CEO of Carolinas and the current chair of the American Hospital Association, would become CEO of the combined system. William Roper, UNC's CEO and the former head of Medicare and Medicaid during the Reagan administration, would be the executive chair.

This is not a merger of necessity. Both health systems have had strong bottom lines and already had dominant negotiating positions. Carolinas posted a 4.3% operating margin in 2016, and UNC had a 5.5% margin, according to audited financial statements.

Our thought bubble: There are a lot of moving parts here, and it may not be easy to merge the cultures of the UNC academic system with the public Carolinas system known for high executive pay. The Federal Trade Commission almost certainly will take an extremely close look at this deal as well, considering the Department of Justice is probing Carolinas for creating insurance contracts that steer patients toward its own system and away from lower-cost providers.

Go deeper

Updated 4 hours ago - Science

Huge wildfire reaches edge of Sequoia National Park

A plume of smoke and flames rise into the air as the fire burns towards Moro Rock during the KNP Complex fire in the Sequoia National Park near Three Rivers, California, on Saturday. Photo: Patrick T. Fallon/AFP via Getty Images

Firefighters in Sequoia National Park were working into the night after two wildfires merged to reach the Giant Forest Saturday.

Why it matters: This forest contains over 2,000 giant sequoias, including the General Sherman Tree — the world's largest tree by volume. Park officials wrapped the redwoods in foil last week as the Paradise and Colony Fires, now known as the KNP Complex Fire, neared. Protection efforts appeared to be working overnight.

4 hours ago - World

Hong Kong holds first "patriots only" elections

Hong Kong Chief Executive Carrie Lam during a news conference last Monday. Photo: Lui Siu Wai/Xinhua via Getty Images

Hong Kong's elections to choose the city's Election Committee members opened to a select group of voters on Sunday, under a new "patriots only" system imposed by China's government.

Why it matters: All candidates running to be members of the electoral college have been "vetted" by Beijing, per Reuters. They will go on to choose the Asian financial hub's next leader, approved by China's government, and some of its legislature.

6 hours ago - World

Israeli forces capture final 2 escaped Palestinian prisoners

An Israeli security forces member on Saturday stands guard at the Gilboa prison in northern Israel, from where the six inmates escaped. Photo: Ahmad Gharabli/AFP via Getty Images

Israeli forces captured the two remaining Palestinian prisoners who tunneled their way out of an Israeli maximum-security prison with four others in a "Shawshank Redemption"-style escape, authorities announced Sunday.

Why it matters: The escape sparked a massive manhunt and turned the prisoners into heroes in the West Bank and Gaza, with Hamas and Islamic Jihad in Gaza threatening an escalation if they were harmed, per Axios' Barak Ravid.