Tenet Healthcare Corp. (NYSE: THC) this morning announced that it has agreed to acquire Vanguard Health Systems Inc. (NYSE: VHS) for $21 a share in cash. The deal is valued at $4.3 billion, which includes the assumption of $2.5 billion in Vanguard debt.

The acquisition is expected to be accretive to earnings in the first year, and Tenet projects annual synergies of $100 million to $200 million.

Tenet operates 49 hospitals and 129 outpatient centers in the United States and a business process company that serves more than 600 other hospitals and health care providers. Vanguard owns and operates 28 acute care and specialty hospitals in selected metropolitan areas.

The acquisition is expected to close by the end of this year, subject to the usual approvals. Tenet said it has “fully committed financing” from Bank of America Merrill Lynch and that the boards of directors for both companies have approved the deal unanimously.

Vanguard’s shares are up 64% at $20.57, after closing at $12.37 on Friday. The stock’s 52-week range is $7.84 to $17.74.

Tenet’s shares are inactive so far this morning, having closed at $41.85 on Friday, in a 52-week range of $17.24 to $49.47.

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