Essentia Health and Marshfield Clinic Health System announced Thursday they have reached an agreement to form a new integrated regional health system for rural and mid-urban communities across four states.

The agreement is the latest step that keeps the organizations on track to come together by the end of this year pending regulatory approval.

“We are both physician-led organizations with an unwavering commitment to the health of rural communities,” said Essentia Health CEO Dr. David Herman, who will be CEO of a new parent company. “Our complementary capabilities will allow us to learn and share with one another to better achieve our collective mission.”

“Discussions the past few months have made it clear that this is an incredible opportunity to enhance both health systems, solidify our futures, and take patient care and services to an even higher level,” said Dr. Susan Turney, who previously announced she will step down as Marshfield Clinic Health System CEO this fall.

By joining, Essentia and Marshfield Clinic will combine the strengths of both organizations and advance the level of care in Wisconsin, Minnesota, Michigan’s Upper Peninsula and North Dakota. The new regional system will bring greater access to primary, specialty and hospital care through a diverse network of 3,800 providers and 150 care sites, including 25 hospitals.

Turney and Herman added that both organizations will be better positioned to navigate current and future challenges to health care, especially rural health care.

Headquartered in Duluth, Minn., Essentia Health serves Minnesota, Wisconsin and North Dakota. It has about 15,000 employees, including 2,200 physicians and advanced practitioners at 14 hospitals, 78 clinics, six long-term care facilities, six living facilities, seven ambulance services and one research institute.

Marshfield Clinic Health System serves Wisconsin and Michigan’s Upper Peninsula with more than 1,600 providers comprising 170 specialties. Primary operations include more than 60 Marshfield Clinic locations, 11 hospitals, Marshfield Children’s Hospital, Marshfield Clinic Research Institute, Security Health Plan and Marshfield Clinic Health System Foundation.