Mergers & Acquisitions

The deal, which still needs regulatory approvals, would end the hospital’s relationship with Stony Brook University Hospital.

Fitch also raised concerns about the deal coming at a time when Tenet is still integrating Vanguard Health Systems, which it acquired for $4.3 billion in 2013.

A number of big deals, involving both for-profit and nonprofit health systems, have recently fallen apart amid pushback from regulators and skepticism from researchers, who note a lack of evidence about long-term quality and cost impacts.

The top M&A in the sector have already totaled more than $64 billion, according to the Healthcare M&A Information Source by Irving Levin Associates.

The deal comes five years after Humana spent $790 million to buy Concentra, a network of 300 urgent care and physical centers and 245 work-site clinics in 38 states.

Deal makes Tenet largest provider of ambulatory services in the United States.

Banner finished 2014 with $8.8 billion in total assets.

However, the 2016 presidential election and potential legislative changes could shift the regulatory landscape and affect certain sectors of healthcare, a trend that could throw off M&A.

Actavis said the newly combined company, which will take on the Allergan name, is expected to net $23 billion in sales in 2015.

The acquisition gives Constellation a foothold in New York, New Jersey and Florida.