Two large mergers changed the look of health care in the region.

Clarion Health System joined Butler Health System as a subsidiary after almost a year of planning.

Plans for the merger started in February with administrators signing an executive agreement in July.

Tangible proof of the partnership started to appear in December as signs changed, but staffs stayed the same.

“There are no staff changes, and yes, BHS and CHS will retain their teams,” Jana Panther of Butler Health System said in November.

BHS employs more than 2,500 people, including about 200 physicians and advanced providers.

Also merging were Grove City Medical Center (GCMC) and Allegheny Health Network (AHN), which the two entities announced in August.

The merger established Grove City as AHN’s ninth owned hospital.

As part of the agreement, AHN and GCMC agreed to fund a new independent Grove City Health Care Foundation with an initial endowment of up to $30 million for health and wellness initiatives in the Grove City area.

AHN also agreed to invest an additional $40 million over the next 10 years to enhance Grove City’s care, programs and coverage.

“Establishing strong partnerships with outstanding health care institutions is a key component of our strategy for building a world-class health and wellness company that provides an unsurpassed experience and the best possible outcomes for our patients and members,” said David Holmberg, president and CEO of Highmark Health, Allegheny Health Network’s parent company.