USofCare Calls on Wake County Commissioners to Secure Commitments on Prices, Services, and Oversight Before Approving WakeMed-Atrium Merger

With North Carolina’s hospital market already among the most consolidated in the country, Wake County residents deserve binding commitments on prices, services, and accountability

Raleigh, NC — United States of Care recently released a letter submitted to the Wake County Board of Commissioners urging them to secure binding commitments from WakeMed and Atrium Health before taking any action that supports a proposed merger between the two health systems. This merger would have major implications for health care costs and access in North Carolina’s largest county. The letter calls on commissioners to secure protections that hold down hospital prices, preserve essential health care services, and maintain local control over key programs and community partnerships.

The research is clear: when hospitals consolidate, they gain leverage that leads to higher prices, less choice, and restricted access for people – often with no improvement in health outcomes. Seventy percent of North Carolina voters say health care consolidation has caused them to experience a financial or logistical challenge accessing care, and 74 percent report having skipped or delayed care because of cost. North Carolina patients are already facing approximately $120 million in excess charges due to facility fees alone, underscoring the need to ensure any further consolidation does not come with more cost and fewer services for people. 

“Wake County residents deserve more than promises – they deserve binding commitments that put patients first,” said Brianna Miller, State Advocacy Manager at United States of Care. “We’ve seen what happens when communities don’t demand accountability up front. Prices go up, health care services get cut, and local control quietly disappears. The Wake County Board of Commissioners has an opportunity right now to set the terms of this transaction and make sure it prioritizes health care for the people who live here – not just the bottom line of a mega-system.”

In its letter, United States of Care calls on the Board to seek commitments in three areas:

• Protecting affordability — including specific price protections to prevent cost increases for people, modeled on conditions like those placed on the Union Health-Terre Haute merger in Indiana. Those conditions established a site-neutrality provision prohibiting the combined health system from reclassifying off-campus clinics as hospital facilities without approval.
• Preserving access to essential and safety net services — including commitments to maintain the Level I Trauma Center, Pediatric ICU, obstetrics, psychiatric care, and pediatric services for uninsured and Medicaid patients, as well as minimum community benefit spending requirements at or above current levels.
• Clarifying governance and accountability — including clear answers on what decisions remain under WakeMed’s local authority, what powers the County retains if commitments are not met, and how community representation will be preserved as WakeMed integrates more deeply into the broader Advocate Health system.

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