Atrium Health made headlines last week with plans to merge with Triangle-based WakeMed — a multi-billion-dollar deal that could reshape health care across North Carolina.
But the proposal quickly drew criticism, both for how it was announced and for broader concerns about hospital consolidation driving up costs.
For more, WFAE's Nick de la Canal spoke with Adam Wagner of the North Carolina Newsroom in Raleigh.
Nick de la Canal: So this was originally supposed to be voted on by the Wake County Board of Commissioners yesterday, right? Catch us up to speed on where things stand.
Adam Wagner: So, the Wake County Board of Commissioners needs to update the incorporation agreement that originally formed WakeMed back in the 1960s, as well as a couple of land transfer agreements. These were announced Friday afternoon — last Friday — on a consent agenda, and they were set to be voted on Monday evening.
After hearing a lot of pushback from state officials like the state treasurer Brad Briner, the state auditor Dave Boliek, as well as a handful of Wake County legislators ... commissioners just decided that they are just going to press pause on this for a minute.
De la Canal: And we've seen several major hospital system mergers in the past few years. Why does Atrium want to combine with WakeMed? What's the business case?
Wagner: The biggest argument for Atrium is that Atrium has a huge presence in Charlotte, obviously. They also have a significant presence in Winston-Salem. So they are looking for a foothold in the Triangle.
De la Canal: But as we've said, there are some state officials who are against this, right? What concerns have they raised?
Wagner: So there's basically two lines of (concern). One is transparency — this was really brought up by state auditor Dave Boliek, who argued that this has been going on behind closed doors, obviously, for a while. So, what do they know? Why do they want it? Can we get the community up to speed on where this deal is before this necessary vote?
The other strand is cost. When hospital systems merge, costs go up. There’s a huge body of research that shows this — costs for patients. This is typically somewhere in the ballpark of 6 to 12%, is what treasurer Brad Briner told me yesterday. That may not sound like that much, but when you're talking about thousands of dollars — expensive surgeries, things like that — that can be huge. And when you're talking about the scale of a state health plan or an insurance plan, that's an awful lot of money.
De la Canal: And to that first point about transparency — I think one thing that did catch a lot of people off guard was the way this news dropped on Friday, with the vote scheduled for Monday. So it felt like maybe they were trying to slip this through without giving time for backlash to build. Have the hospitals responded to that?
Wagner: Yeah, there’s definitely a sense of that, especially among some of the lawmakers. You saw Erin Pare tweet about this on Monday, even.
The hospitals say that they needed to do this deal quietly — that they were really doing the work in the background on each other. That's been going on for two years. This deal dates back in some ways to a COVID-era partnership between WakeMed and Atrium around cancer care, and that really got the systems talking, and they realized they're aligned in a lot of ways. They both started as community hospitals. And those conversations built and built and built until we got to where we are today.
