Two North Carolina-based health systems, Atrium Health and WakeMed Health, announced plans to merge last week. As part of the proposed deal, Atrium plans to invest $2 billion into WakeMed and create 3,300 new jobs in Wake Country, North Carolina.
The deal already appears to be off to a rough start, though. The Wake County Board of Commissioners was set to vote to advance the transaction on Monday, but it postponed, citing concerns about transparency and the pace of the deal.
Charlotte-based Atrium is the largest health system in North Carolina, and it’s also part of Advocate Health, the country’s third-largest nonprofit system. The entity was formed in 2022, when Illinois-based Advocate Aurora Health and Atrium merged.
Atrium currently operates 40 hospitals and more than 1,400 care locations across the Carolinas, Georgia and Alabama.
Raleigh-based WakeMed operates three acute care hospitals, a mental health hospital and a physical rehabilitation hospital. Its competitors in the metro area include UNC Health and Duke Health.
The organizations say the merger aims to improve clinical services and boost health outcomes in Wake County. But state leaders were sounding off about it over the weekend.
For instance, North Carolina State Treasurer Brad Briner declared that the deal “will increase already high healthcare costs with no meaningful investment in Wake County,” in a post on X.
He sent a letter to the Wake County Board of Commissioners arguing that consolidating two large health systems would reduce competition in the region, therefore giving the combined entity more leverage to negotiate higher prices with payers. Briner urged the board to either reject the transaction or require a substantial financial endowment — “well over $1.5 billion” — from Atrium to help offset future price hikes.
North Carolina State Auditor Dave Boliek sent a letter to the board over the weekend as well. He said the deal appears to lack sufficient clarity and public accountability given its size and potential long-term impact on healthcare costs.
“The rollout of the proposed hospital takeover raises questions. The lack of transparency does not instill confidence, in fact, it calls for greater scrutiny and explanation,” Boliek wrote.
It’s also highly unlikely the average Wake County resident “is even aware of the pending takeover,” he added.
The board decided to heed the concerns brought forth by Briner, Boliek and other policy leaders. In a statement issued on Monday, it said delaying its vote to allow for more input from the public.
“The board made this decision to provide time for the hospitals to engage with the community, so they — along with the County Commission — can hear residents’ comments and concerns about the combination,” the statement read.
The early backlash suggests the merger might face a longer and more contentious road ahead.
Photo: Jordan Lye, Getty Images
