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PROVIDENCE— Rhode Island’s two largest health care systems announced late Monday that they have taken the next steps to merge their two organizations. Lifespan Corporation and Care New England filed their merger application with the Hospital Conversion Act with the state health department and the Attorney General’s office on Monday afternoon, according to Kathleen Hart, a Lifespan spokeswoman.

This comes after the two systems submitted their application on April 14 with the Hart-Scott-Rodino Act antitrust filing with the Federal Trade Commission.

The organizations said in a statement that they expect the regulatory approval process to “take several months.” If approved, the newly merged system will become the state’s largest employer.

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Lifespan owns the Rhode Island, the Miriam, Hasbro Children’s, Newport, and Bradley hospitals and is known for its work in neurology, cardiology, orthopedics, pediatrics, and cancer treatment and care. Care New England owns Women & Infants, Kent, and Butler hospitals and has expertise in family medicine, obstetrics, gynecology, neonatology, and adult psychiatry.

In mid-February, the systems announced that they had signed a definitive agreement to merge and create an integrated academic health system with Brown University. In addition, Brown has committed to providing a minimum of $125 million over five years in support of the development of the integrated academic health system.

Lifespan and Care New England have attempted to merge several times in the past, with no success. But in a relatively small market, the two competitors have each had their own sets of financial pressures which have heightened due to the COVID-19 pandemic.

Some observers note that the deal would increase access to care for many consumers, but critics have said the merger could lead to less competition, more job cuts, and a hike in care costs.

On a call Monday night, Representative David N. Cicilline, a Rhode Island Democrat and chairman of the House Judiciary Subcommittee on Antitrust, Commercial, and Administrative Law, spoke broadly about a merger of this size.

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“In a health care system, you want to make certain that we’re protecting the quality of care, the costs of care, and make sure that additional costs aren’t created as a result of the merger,” said Cicilline. “And you want to look at the implications on the workforce, the implications on innovation, and any other things that large transactions can produce.”

After the health care systems announced they had filed, the Rhode Island Foundation on Monday said it would lead an “independent effort to gather and share community input.” In a press release, the Foundation said it will “coordinate an independent effort, of research and inclusive committee input, to inform the intentional community-building efforts of the proposed integrated academic health system.”

The community input effort will be gathered by a broadly representative team and will likely include public opinion research, convening community listening sessions to “promote transparency and gather feedback,” and inform decisions, according to the Foundation’s announcement.

The committee will include members of the Foundation-convened Long Term Health Planning Committee that developed the Healthy in Rhode Island plan. It is co-chaired by Neil D. Steinberg, chief executive of the Foundation, and Jane Hayward, chief executive of the Rhode Island Health Center Association.

“Our goal is to gather feedback and ideas from Rhode Islanders, including those who may not otherwise have a voice in this process,” said Steinberg. “We’ve worked with Lifespan and Care New England and have been supportive of the idea of a locally-controlled integrated academic health system for many years. We’re pleased to see the formal merger process moving forward. That said, the community’s voice must remain an integral part of both the planning around, and implementation of, the merged entity.”

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This group’s plan includes a focus on reducing racial and ethnic health inequities.

“The proposed creation of an integrated academic health system for Rhode Island through the merger of Lifespan and Care New England could be a transformational step for Rhode Island’s health care delivery system,” said Hayward in a statement. “It is critical that there be a robust and independent process to gather input from the broader Rhode Island community, with particular intentionality around those communities that have experienced historical barriers to accessing care.”


Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her on Twitter @alexagagosz.