What the WakeMed Merger Means for Patients

What the WakeMed Merger Means for Patients

The potential WakeMed-Atrium merger is on hold—but the questions and concerns it raises aren’t.

By Emily O’Brien + Heidi Reid

Raleigh’s largest nonprofit healthcare system may be entering a new chapter. In early May, WakeMed announced a move to merge with the state’s largest healthcare system, Atrium Health. If approved, the proposed partnership will reshape local healthcare in Wake County—but whether patients ultimately benefit remains a matter of debate. 

For many Raleighites, WakeMed is a lifeline. It’s where emergencies land and specialists are tapped for diagnoses and lifesaving care. And as the county’s only Level I Trauma Center, it’s long been a medical mainstay. 

But as details of the proposal emerge, those who rely on the institution—and those employed by it—are trying to parse what it could actually mean for their well-being. 

WakeMed says the merger would expand specialty care, behavioral health services and enhanced treatment options, while also establishing the state’s largest virtual care network. Unanimously approved by WakeMed’s board after a three-year evaluation, the merger was expected to be approved by Wake County Commissioners just three days (and less than 10 business hours) after the initial announcement. 

But county commissioners weren’t convinced, delaying a vote for 90 days—until at least August—to allow for additional review and community input before moving forward.

NC Treasurer Brad Briner argued the proposal would drive up already-high healthcare costs and offer little return for Wake County, while State Auditor Dave Boliek raised concerns about the deal’s transparency and pace. 

“The people of Wake County and stakeholders who are affected by this move deserve to have more than a weekend to voice their opinions on a hospital takeover of this scale,” Boliek said in his call to delay the vote. 

Photo by Wileydoc/shutterstock.com

State health execs note Atrium is currently charging 15% to 40% more than WakeMed for the same services. If WakeMed opts to raise its rates to similar levels post-merger, every NCer on the State Health Plan would see an increased cost of yearly premiums—up to $132 more. 

While both WakeMed and Atrium Health maintain no immediate changes are planned for insurance acceptance and in-network status, care or coverage, patients are still raising red flags: Will insurance still be accepted? Will appointments become harder to get? Will costs actually rise?

A long-time WakeMed patient told RM she learned of the proposal through news reports. “I’m concerned about whether or not they’ll still take my insurance, and how much I’ll have to pay per visit going forward,” she stresses.

Meanwhile, WakeMed President and CEO Donald Gintzig dismissed concerns about rising costs and maintained the merger would lead to better quality care. “This is not about getting bigger for bigger’s sake,” he tells RM. The comments echoed broader messaging at several public forums held in late May to address concerns and increase transparency. 

The merger reflects a growing reality for WakeMed. In one of the nation’s fastest-growing regions, expanding services may be necessary to keep up with demand. 

To WakeMed, the partnership is less a business transaction and more a strategy for keeping up with that explosive growth. “Do I think WakeMed will survive in the future [without this merger]? Yes,” admits Gintzig. “But I can see a world where it doesn’t thrive—and that’s really what this is about.” 

Though Gintzig said the org is fiscally sound, the healthcare landscape has changed over WakeMed’s 65 years. “Without combining resources with a like-minded organization, WakeMed will face greater challenges alongside a significantly extended timeline for growth and expansion, making independence unsustainable,” he maintains.

The proposed partnership includes a reported $2 billion investment in Wake County and increased charity-care eligibility from 300% to 400% of the federal poverty level. Read: Families of four earning less than $100K annually could qualify for free care.

Additionally, the merger will maintain WakeMed’s influence amid Medicaid cuts and local competition, Gintzig adds. And in more immediate concerns, the hospital’s main campus on New Bern Avenue needs at least $1B in redevelopment. 

Thanks to the promised perks, some staff members back the partnership. WakeMed ENT physician and director of head and neck surgery Dr. Michael Ferguson says he wouldn’t work for an institution that wouldn’t allow him to care for his patients in a way he sees fit. “I have confidence Atrium will allow all WakeMed physicians to continue to thrive just as we have for the past 65 years,” he stresses.

Independent research of similar mergers yields mixed reviews: Some markets saw expanded services, but others experienced increased pricing as competition narrowed —with no change or decrease in care quality. Similarly, contention took over Wilmington in 2021 as commissioners approved the sale of the county hospital to Novant Health. 

Years later, locals still note a decrease in care quality—and blame the deal. “Did they do a  case study of Wilmington and Novant?”one NCer commented on a WakeMed merger post. “Spoiler alert. It’s not going well here.” 

Amid the controversy, the changes patients have been asking for are still not definitive—the possibility of easier specialist access, decreased wait times or lower costs remains uncertain. 

For now, the answers many patients want most—whether care will become more accessible, more affordable or simply remain the same—are still unclear.

If county commissioners decline to approve, Gintzig says, WakeMed would abide by their decision, but the impact would eventually be felt. “It’ll be alright,” he says. “It just won’t thrive as much. And that’s a shame.” For now, the merger remains on hold—and so do many of the answers Wake County patients are waiting for.

Emerging District

Emerging District

Collaboration and big-picture thinking produce a proposed new district.

If you’ve seen Yellowstone, you know property ownership and inheritance dealings can turn ugly quick. But when Wake County, WakeMed and Wake Tech VIPs assembled to discuss the future of the area surrounding WakeMed’s campus off New Bern Avenue in Southeast Raleigh—where each institution owns a portion of land—there was no contention. Instead, the three parties decided to throw out property lines and work together to create a health and education district that would benefit everyone.

A remarkable unprecedented move spawning a major impact on Raleigh for years to come, the project will be transformational not just for Southeast Raleigh, but for the entire New Bern Avenue corridor—aka “the gateway right into Downtown,” says Tom Cavender, WakeMed’s VP of facilities and construction. Think green space, pedestrian- and bike-friendly paths, and a quad-like feel augmenting the area and adding to the bus rapid transit construction already underway.

“The synergy that will come from this collaborative effort will reach far beyond the borders of these three institutions to impact the entire community in a very positive way,” says former Wake County Commissioner Sig Hutchinson—“from affordable housing to active lifestyles to creating healthy communities to health care services to educational opportunities.”

According to Cavender, what spurred the project was “essentially a confluence of energy between Wake Tech, WakeMed and Wake County… a situation where the sun, stars and moon all aligned.” In short, Wake County received bond money to build a replacement public health center at New Bern Avenue and Sunnybrook Road—nearly adjacent to both WakeMed and Wake Tech—at the same time Wake Tech and WakeMed were collaborating on long-term plans.

So Cavender called Jeff Carter and Mark Forestieri, his Wake Tech and Wake County counterparts, respectively, and said, “What if we just sat around a table… and thought through a way we can better utilize what we have available to us? It’s a great public-private partnership.”

They gathered key players from each org, and “we said, ‘Peel all your allegiances away: What’s best for all of us when we look at this massive 135 acres of land we have between us?’” Cavender recalls. Everyone was on board—and the idea for a health and education district was born. 

“It truly was this notion of an opportunity for everybody to win, and I think that’s what’s going to happen,” says Wake Tech President Dr. Scott Ralls. “Health care needs from our area are going to continue to grow because we’re growing—and we’re growing older at the same time. … We’re the largest higher-ed provider of health care in Wake County and one of the largest in the region, so that’s a key expansion area for us.”

While WakeMed will inherit adjacent land from Wake County for replacement facilities, Wake Tech will gain significant acreage from WakeMed on the Falstaff Road side to achieve its desired growth. “Right now we’re investing $121 million in the initial expansion for our education part of the campus, so it’s going to mean some big opportunities for Wake County and for the future,” reveals Dr. Ralls.

According to Cavender, the entire district is currently in the rezoning stage and will most likely go to City Council for approval by the end of 2024. If it passes, we could be seeing cranes in the sky by this time next year. The rest is still unwritten because, as Hutchinson points out: “These three institutions erased the property lines and redrew them so each institution would benefit from what they needed versus what they owned. Nothing like this has ever been done before.” 

Cavender notes the trio served as the “key component to get this thing off the ground and rolling.” But now he’s hopeful more of WakeMed’s partners and developers willing to invest in the area with speculative incubator buildings will want to join the district.

“We’re being very judicious and purposeful in our thinking,” says Cavender, nodding to child abuse prevention nonprofit  SAFEchild’s 20,000-square-foot facility on the campus as an initial partnership to pave the way for further such community collaboration. He also hopes it will serve as a magnet to draw people to the school and to businesses in the area.

“I’ve never seen anything like it,” says Hutchinson. “There is such tremendous leadership in all three of these institutions, and I just continue to be amazed at what they can deliver as a model for not only North Carolina, but also for the rest of the country.” 

Wake Tech Phase 1 Plans

  • New parking garage
  • Cutting-edge 106,000-square-foot addition to its Perry Health Sciences Campus—approximately half of which will be a simulated hospital
  • Expansion of the nursing program and imaging program
  • Imaging program will boast a partnership with Siemens, making it one of the most high-tech training centers in the nation.
  • Two additional building sites available to support Wake Tech’s long-term future growth