As hospitals in Northeast Pennsylvania have joined with larger health care systems, the region is now better equipped to care for patients once forced to travel for treatment. For decades, area hospitals operated independently, often struggling financially. Cash-strapped, the hospitals could not afford many specialists, forcing patients to travel outside the region for care. A trend that began in 1999, when Tennessee-based Community Health Systems acquired Berwick Hospital, has helped change the landscape of health care in the region. In more than a dozen years, a dozen hospitals in Northeast Pennsylvania have merged or become acquired by two nationally known health care systems - CHS and Geisinger Health System. Both companies have upgraded facilities, added more specialty care, improved technology and promised more.