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Two not-for-profit Midwest hospital systems are seeking to merge, creating what would be a health care powerhouse with nearly $14 billion in annual revenue.

Sanford Health, a 47-hospital system based in Sioux Falls, S.D., and Fairview Health Services, an 11-hospital academic health system based in Minneapolis, said Tuesday they’re giving their union a second shot after an initial bid failed about a decade ago.

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