Highland Park Hospital would carry the Rush name under a proposed merger between Endeavor Health and Rush University System for Health.

The two nonprofit systems announced the deal Wednesday, Oct. 14. The combined organization would include 12 hospitals, more than 46,000 employees and over 400 care sites across northern Illinois and Northwest Indiana, as first reported by the Chicago Tribune.

That would make it one of the largest health system in Illinois by hospital count, edging past Northwestern Medicine and Advocate Health Care, which each operate 11 hospitals.

What changes for patients

Endeavor President and CEO J.P. Gallagher said patients should expect more access to care closer to home, more clinical trials and likely more outpatient locations. A hospital spokesperson said the merger would not mean closures, according to NBC Chicago.

All hospitals in the merged system would adopt the Rush name alongside their location. Highland Park Hospital would become a Rush-branded facility. The Endeavor name would be phased out over time.

Rush University Medical Center tied with Northwestern Memorial Hospital for best hospital in Illinois in U.S. News & World Report's annual rankings, according to the Tribune. Gallagher said the Rush brand was chosen because of its 150-year reputation as an academic medical institution.

Concerns about cost and competition

Not everyone is cheering the deal.

Zachary Levinson, project director of KFF's Project on Hospital Costs, told the Sun-Times that the research record on mergers is clear: "There's now a substantial body of evidence finding that consolidation has lead to higher prices without clear effects on quality."

Endeavor's predecessor, NorthShore University HealthSystem, tried to merge with Advocate Health Care in 2014. The Federal Trade Commission (FTC) challenged that deal, arguing the combined system would control more than 50% of inpatient services in the North Shore area. A federal appeals court sided with the FTC, and the two systems abandoned the merger in 2017.

Gallagher said the systems have already begun talking with regulators and expects the process to go smoothly. The deal requires state and federal approval and is targeted to close in early 2027.

Nurses watching closely

The announcement lands as nurses at both systems push to unionize. Nurses at Endeavor hospitals in Evanston, Skokie, Glenbrook and Highland Park have been organizing under Teamsters Local 743, citing pay cuts and staffing concerns, WBEZ reported in May. Nurses at Rush University Medical Center voted earlier this year to form a union under the National Nurses Organizing Committee.

In a statement reported by the Sun-Times, Teamsters said the proposed merger "highlights why nurses need representation."

Gallagher said nurses are "vital to our mission" and that Endeavor has made "very significant investments" in its nursing staff.

Leadership and next steps

Gallagher would become president and CEO of the merged system. Rush President and CEO Dr. Omar Lateef, who had previously announced plans to retire in 2027, would serve as CEO emeritus and strategic adviser. A 20-member board split evenly between Rush and Endeavor members would govern the system, led by a chair from Rush.

The Illinois Department of Public Health said it has not yet received an application for a certificate of exemption for a change of ownership, NBC Chicago reported.