West Virginia University Health System and Independence Health System announced plans to merge in November 2025, a move leaders say will expand access to specialized care and strengthen services across Western Pennsylvania, making Butler Memorial Hospital one of its “tertiary hubs” for health care.

The merger would bring Independence Health System — which includes Butler Memorial Hospital and other facilities serving Butler County — into WVU Medicine’s broader health network.

The goal to finalize the agreement by this fall.

Officials say the partnership is designed to improve access to specialty care, invest in local facilities and apply WVU Medicine’s rural health care model, which has been used across its existing system to expand services in smaller and underserved communities.

For Butler County, where many residents live in rural areas, leaders say the approach could help reduce the need for patients to travel long distances for advanced treatment while strengthening Butler Memorial’s role as a regional care center.

“The transition is going very well,” said Ken DeFurio, president and CEO of Independence Health System. “We are on time, no delays or snags. Another part of this is regulatory review from both the federal and state government. The Federal Trade Commission at the federal level and the attorney general’s office in Pennsylvania. That comes after the definitive agreement is negotiated and submitted to them. That will happen on or before July 1. We sent preliminary information to them in January so they would know what is going on.”

Once a definitive agreement is reached by both parties and submitted to the state and federal government, they have up to 90 days to approve it, DeFurio said.

“We are hoping to have everything taken care of and officially part of WVU by Oct. 1,” DeFurio said. “Those dates we announced a while back and they have not changed. There is nothing telling me we will not hit that.”

DeFurio said regulatory review by the government is about two things. One being antitrust, which means regulators want to see more competition, not less, when two organizations join forces like this.

“The other high-level thing is to make sure charitable assets are maintained,” DeFurio said. “Both organizations are charities by definition. We just need to make sure any assets we have on our balance sheets are in fact are being put toward health care in our communities.”

While regulatory review isn’t the most “sexy” topic according to Albert Wright, president and CEO of WVU Medicine, it needs to be done none the less to make sure this transaction goes through smoothly.

“As these things wrap up, we really head into the final due diligence phases of dotting I's and crossing T’s,” Wright said. “There is a ton of documents you go through and start to figure out what the structure might look like.”

One of those projects will be an expansion of the Butler Memorial Hospital Emergency Department, Wright and DeFurio said.

“We don’t want to disrupt operations,” Wright said. “We want to have a couple projects where we put a couple shovels in the ground in October of this year to show communities how serious we are about creating even better health care in Butler County and all the places we will be operating in.”

Another project Butler community members will notice early on after the transition is the expansion of Butler Memorial Hospital’s women’s health services DeFurio said, but it won’t stop there.

“Given the way health care is provided these days, most of it doesn’t happen in the walls of the hospital, so there will be an investment in ambulatory services across Butler County,” DeFurio said. “We will work through that and figure that out. That will include more physicians and testing.”

These investments were announced when the letter of intent was signed in November 2025, when West Virginia University Health System said it will invest $800 million over five years to modernize Independence Health System’s operations with $200 million earmarked for capital improvements.

DeFurio said Independence presented WVU Medicine with a list of projects it would like to tackle, which included an expansion of the emergency department and women’s health services.

“We call it strategic capital,” DeFurio said. “Meaning here is money we would like to have available to have strategic investments that we have not been able to do. We also presented them our routine capital spending — meaning replacing CT scanners, to roofs on a building and so on. Our typical spending in a five-year span for that is about $200 million.”

Another major component of the proposed merger is an overhaul of the system’s electronic health records. According to the letter of intent for the transaction, WVU Medicine has committed $80 million to install a new health records system from Epic Systems.

The goal of these investments, particularly at Butler Memorial Hospital, is to turn BMH into one of WVU Medicine’s “tertiary hubs” within its system, that provides complex, specialized and technologically advanced care for patients.

“What we are going to do is try and make sure BMH is as comprehensive as it can be for the community,” Wright said. “That includes enhanced cardiac procedures or advanced neuro procedures or spine care. Also our cancer capabilities and clinical trials so folks don’t have to go to Pittsburgh or Morgantown. Those are the things we are really going to start to look at.”

Essentially, WVU Medicine intends to make BMH a one-stop shop for health care, DeFurio said.

“The only thing at the end of the day it comes down to is patient choice,” DeFurio said. “There is no intention or expectation patients will have to go to Morgantown for high-level care. This investment is to prevent people to have to go anywhere else other than here. One-stop shop is a good way to put it. It is just a really good thing for the community.”

If the merger is approved, WVU Medicine would assume all of Independence’s current debts. which, according to DeFurio, sits at around $110 million.

“When you add those debt guarantees in, it's about a $1 billion commitment to the health system,” DeFurio said. “If someone comes around and says they will pay off the mortgage on your house, that’s a pretty big monkey off your back.”

Once combined, the new health care system will have about 42,000 employees, with about 35,000 of those from the WVU Medicine system.

The letter of intent states that all employees will have their position guaranteed for a year once the merger goes through. If things go as planned, both presidents don’t anticipate layoffs past that one-year mark.

Wright said that WVU takes things a step further to ensure its employees are taken care of. For example, any three-year employee of WVU Medicine can send a child to WVU without cost.

Another motivation for the merger, according to DeFurio, was the ability to partner with Peak Health, a nonprofit health insurance provider partially owned by WVU Medicine. Unlike its competitors, UPMC and Allegheny Health Network/Highmark, Independence Health System is not currently integrated with a health insurance provider.

“They use that to control costs, but how do you do that?” DeFurio said. “You make sure patients get what they need, but you want that to happen at the lowest cost possible. You can share information with providers and patients and keep costs under control. We are really working toward the solution and not be part of the problem.”

Wright said he hopes to expand Peak Health to offer advantage plans.

DeFurio believes the partnership with WVU Medicine makes sense because it has had great success implementing rural health care due to the demographics of its coverage area. Both presidents feel that model will fit well in Western Pennsylvania.

“West Virginia is hard to serve in terms of health care,” DeFurio said. “They are very rural and hard to get to. Not only do they have a commitment to health care services, but also rural health for people who don't have a lot of means.”

Wright said there isn’t a big secret to making rural health care successful, as it involves simply committing resources — both capital and with employees — to make sure residents have the best health care available.

“In Wheeling, we have done a great job at building up orthopedic capabilities and neurosciences,” Wright said. “I think for someone like Ken, he looks at a model like ours and says hey he wants to build these up and do that in Western Pennsylvania.”

Wright said the partnership with Independence Health System makes sense because of a strong cultural fit and a growth mindset on both sides.

“We wouldn’t be doing this if we didn’t have a growth mindset,” Wright said. “We are not coming up to shrink these facilities and lay people off or cut services. I’m sure once they see the investments being made both capital and physicians recruitment, I think any concerns they have will fade away.”