Ardent Health to Acquire Boone Health for $47 Mn

The acquisition, expected to close in the first quarter of 2027, will include the 392-bed Boone Hospital Center, Boone Health Medical Group, 19 sites of care, related ancillary services and associated real estate.

Ardent Health has entered into a definitive agreement to acquire Boone Health, a not-for-profit health system based in Columbia, Missouri, for $47 million in cash. The transaction will expand Ardent's presence into Missouri and include a $200 million capital commitment over 10 years to support facility upgrades, technology investments, physician recruitment, and expanded access to care.

The acquisition, expected to close in the first quarter of 2027, will include the 392-bed Boone Hospital Center, Boone Health Medical Group, 19 sites of care, related ancillary services and associated real estate. The transaction is subject to customary closing conditions.

Boone Health generates approximately $480 million in annual revenue and serves Columbia and 26 counties across Mid-Missouri. The health system has operated independently since 2021 and has served the region for more than 100 years.

In 2025, Boone Health's Board of Trustees and Board of Directors began searching for a strategic partner to provide additional capital and resources to support its growth. Ardent was selected following a comprehensive evaluation process led by an independent advisory firm.

"Boone Health has built an outstanding reputation for quality, nursing excellence, patient care and outcomes, and we are honored its Board of Trustees and Board of Directors selected Ardent as its partner for the future," said Dave Caspers, president and chief executive officer of Ardent Health. "This agreement advances our disciplined capital allocation strategy and provides a significant opportunity to expand patient access, strengthen specialty services and invest in care delivery. We are committed to investing in Boone Health’s facilities, technology and people so the organization can continue delivering high-quality healthcare to residents of Columbia and the 26 counties of Mid-Missouri for generations to come."

Under the agreement, Ardent has committed $200 million over 10 years for equipment, facility renovations, new facilities and services, physician recruitment and information systems. Near-term priorities include expanding the emergency department and modernizing operating rooms.

The agreement also includes maintaining Boone Health's essential hospital services, continuing employment for all active employees, physicians and advanced practice providers in good standing, and retaining its existing charity care policy. A local advisory board will also be established for Boone Hospital Center to provide Columbia and Mid-Missouri stakeholders with an ongoing role in hospital operations.

"In Ardent, we identified a partner that supports our mission, respects our culture and can accelerate our vision without compromising what makes Boone Health special. Following a thoughtful review, the Board is confident Ardent is the right long-term partner for Boone Health. This agreement protects what our community has built while giving Boone Health the resources it needs to grow," said Jerry Kennett, MD, chair of the Boone Health Board of Trustees.

Financially, the transaction is expected to be modestly accretive to Ardent's Adjusted EBITDA in the first year, increasing to 6-8% accretion in the third year. Ardent also expects to achieve at least $30 million in integration synergies by year three.

Ardent and Boone Health will continue operating as separate organizations until the transaction closes, with no immediate changes to patient care, employee roles or day-to-day operations.

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