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Ascension Health and Providence St. Joseph Health are in talks to merge and create the nation's largest hospital chain, the Wall Street Journal reported Sunday. A merger between St. Louis-based Ascension and Providence out of Renton, Wash., would give the combined not-for-profit entity 191 hospitals in 27 states and annual revenue of $44.8 billion. The deal would put the merged company ahead of HCA, which has 177 hospitals and reported $41.5 billion in 2016, according to Modern Healthcare data. Ascension, the nation's largest Catholic system and which owns 15 hospitals in Michigan with $3.8 billion in revenue, declined to comment on the report. Providence, the nation's No. 2 Catholic hospital chain, did not respond to a request for comment.