Advocacy Groups Speak Out Against WakeMed’s Proposed Merger with Atrium

Representatives from a coalition of local and statewide advocacy groups spoke against the pending WakeMed-Atrium Health merger at a press conference before the Wake County Commissioners’ meeting Monday afternoon.

No related action item was on the agenda, but the end of the county commissioners’ 90-day delay of a vote that would allow the deal to move forward is approaching.

The nearly 20 advocates assembled outside of the Wake County Justice Center called for commissioners to “vote no” on the $2 billion deal that would combine the Wake County-based WakeMed, an independent nonprofit hospital system, and Charlotte-based Atrium Health, the state’s largest hospital system. Protesters argued that the consolidation would raise costs without improving quality of care, and that profit was the deal’s sole aim. 

Signs read “NO ATRIUM TAKEOVER” and “WAKEMED IS OUR HOSPITAL.”

“Atrium is promising growth, but bigger does not mean better for patients. Bigger often means higher prices and less accountability. We want this merger blocked,” said Portia Rochelle, executive committee member from the Raleigh-Apex branch of the National Association for the Advancement of Colored People (NAACP).

WakeMed’s board of directors already quietly sealed the deal with Atrium this spring, an agreement two years in the making. Wake County can’t technically approve or veto the deal itself, though the commissioners must sign off on changes to WakeMed’s articles of incorporation and property agreement for it to move forward.

But when a motion to enact those legal changes appeared on the commissioners’ routine consent agenda in early May, just three days after Atrium announced the merger, public outcry ensued: Critics deemed the deal rushed and void of transparency, citing concerns about costs rising due to decreased competition and poorer quality of care. The backlash pressured the commissioners to delay the vote and allow public input until August. 

“I guess we could wait until it’s all done, before we could do anything,” Rob Stephens, organizing director at the Patients Union, said in response to a “why now” question at the press conference. “I mean, they wanted this never to happen. That’s why they had [short] notice—10 business hours—after being behind closed doors for two years.”

The demonstrators also included representatives from the Men of Southeast Raleigh, the North Carolina Justice Center, the North Carolina Poor People’s Campaign, and the Unitarian Universalist Justice Ministry of North Carolina. The groups voiced concerns that the merger would equate to an Atrium takeover of WakeMed, surrendering county oversight of its flagship hospital—a critical resource to Southeast Raleigh, a historically Black area. 

That fear isn’t unfounded. Atrium would gain the sole authority to amend WakeMed’s governing documents and direct authority to appoint six of the system’s 14 board seats. While the Wake County Commissioners would still appoint the other eight, they can only be nominated with the WakeMed board’s supermajority vote—effectively giving veto authority to Atrium. 

Greg Jarrell, a reverend and organizer from Charlotte, spoke of how Mecklenburg County has struggled to maintain its input into Atrium’s decisions, particularly board nominations. He warned Wake commissioners against giving away the public’s influence. 

“You cannot vote away your own power, because you will never get it back. And all Wake County residents will end up paying the cost,” Jarrell said at the press conference.

Local community groups weren’t the only ones with a showing at Monday’s commissioners’ meeting. WakeMed providers and executives also took the microphone inside county chambers.

Dr. Daniel Fox, a critical care physician and the director of adult and pediatric hospital medicine at WakeMed, said Atrium is a like-minded and familiar partner that can provide needed resources without fundamentally changing WakeMed’s care and connection to the local community. He added that he felt Atrium was a good collaborator during the COVID-19 pandemic.

“Our patients need us to have access to the clinical resources, physical infrastructure, technology, specialty debt, and capital investment that are required to continue to do this great work right here in Wake County,” Fox said to commissioners.

Carolyn Knaup, a WakeMed executive, said she was on the team that evaluated the Atrium partnership. She said their “one central goal” was “strengthening and protecting WakeMed’s traditions and its vital role in our community.” A member of the public murmured “profit” before she could finish.

An additional two WakeMed representatives voiced similar sentiments. Then, a slew of community members took the stand to argue the merger motive was profit. Many cited a Brown University School of Public Health submission to the county commissioners that calls the WakeMed-Atrium deal as a “de facto cross-market merger,” warning of multiple concerns and advising commissioners to block the consolidation. 

The report states the proposed merger threatens to increase health care costs, as mergers of its kind have been linked to price hikes of 7% to 17%. It also states that affordability may decline for low-income patients, since WakeMed’s charity care policy covers all medically necessary services, while Atrium’s is narrower, excluding “non-urgent” services which can be postponed.

Despite concerns that the merger is only going to yield higher profits for the system, WakeMed and Atrium have promised that patients will see improvements to the breadth of care offerings and community support.

At a county commissioners’ work session last month, WakeMed presented its goals for the merger, including expanding its hospitals in Southeast and North Raleigh, Cary, and Garner, advancing specialty care, and opening the state’s largest mental health network with more than 360 beds and expanded access statewide. WakeMed President and CEO Donald Gintzig told commissioners WakeMed hopes to add more than 3,000 local clinical, research and support positions over the next five years. 

Also at the June session, WakeMed board member Margaret Bratton added that, along with WakeMed’s $2 billion investment in capital projects over the next decade, the merger will allow more contributions to unreimbursed patient care, community outreach, education, and health improvement contributions. The consolidation would also support economic development in Southeast Raleigh.

Wake County Commission Chair Don Mial has spoken in favor of the pending merger. At Monday’s meeting, though, commissioners didn’t comment. The nine members appeared to listen intently, some jotting notes, as each speaker took the stand, some warning that the merger decision would be the most consequential of their tenures. 

A vote is expected later this summer.

Comment on this story at [email protected].