Sanford Health and Fairview Health confirmed Tuesday that the two Great Plains health care systems intend to merge, creating the largest health care system in the Upper Midwest.

The merger would unite Sanford, the country’s largest rural health system, with a geographically adjacent health system in Minnesota. The union would give Sanford access to major metropolitan markets in the Twin Cities.

The two health systems employ about 80,000 people combined.

The merger was first reported by The Dakota Scout.

NEWS: Sanford Health in merger negotiations with Minnesota-based Fairview