St. Vincent Regional Hospital is at the center of one of the most significant healthcare investments in Montana's history — and the Billings skyline is already shifting because of it.

A nearly $1 billion new hospital construction project is rising fast on the St. Vincent campus at 27th Street and 12th Avenue North, where vertical structural steel has begun its climb toward a final 14-story profile.

Seven floors remain before the structure reaches full height — a milestone that signals just how far this once-in-a-generation hospital building project has come since crews broke ground in summer 2025.

The finished facility will span 737,000 square feet and house 243 patient beds, each designed with the flexibility to convert to intensive care-level capacity when demand requires it.

The structural steel phase is expected to complete in early 2027, with the full facility targeting a 2029 opening.

One of the most anticipated features of the new design is the consolidation of imaging services — a change that officials say will meaningfully improve how patients experience care from the moment they arrive.

Currently, imaging departments are scattered across multiple wings of the existing facility, requiring patients to move through different areas just to receive results or complete a procedure.

The new building resolves this entirely by placing all imaging services in one centralized location.

Imaging leadership, which had direct input into the building's floorplan and equipment layout, says the redesign prioritizes patient workflow — arriving once, staying in one place, and moving through diagnosis without unnecessary friction.

St. Vincent's leadership has also been candid about the infrastructure reality driving the project — the aging existing buildings simply made more sense to replace than to renovate piece by piece.

Once the new facility opens, the current buildings will be demolished, with reclaimed land earmarked for expanded parking and open green campus space.

The cranes now rising above downtown Billings are more than construction equipment — they signal a region doubling down on its most essential public institution.