‘A lot less bad’: Wake commissioners approve updated deal to combine WakeMed and Atrium

The Wake County Board of Commissioners voted 5-2 late Monday to approve a controversial merger between WakeMed and Atrium Health.

The vote came after a five-hour public hearing during which deputies cleared protesters from the chambers as commissioners were preparing to vote on the transfer agreement.

Atrium has pledged $2 billion in hospital improvements. WakeMed President and CEO Donald Gintzig has said that funding is vital as the county continues to grow.

WakeMed is the largest health system in the state’s largest county. The community hospital has served Wake County residents since 1961. In contrast, Atrium Health is a massive healthcare system with over 70,000 employees across 40 hospitals serving the Carolinas, Georgia and Alabama.

Longtime county residents, health advocates, and state employees voiced opposition to the merger, saying it would lead to higher healthcare costs, less charity care, and a likely reduction in hospital staffing, based on Atrium’s practices in other communities where it operates.

Governor Josh Stein, who voiced early reservations about the merger, entered the negotiation process over the weekend and by Sunday announced he would not stand in the way of the deal because Atrium had agreed to changes Stein said he requested.

Stein said improvements to the initial proposal included a sizable increase in charity care, a $150 million community benefit fund for Wake County, and a clarification that Atrium would make the $2 billion investment from its own assets, not WakeMed’s, over a 15-year period.

Stein said Atrium also agreed not to increase prices at WakeMed more than 1.5 times the annual increase in Medicare costs for the next five years.

After the commission voted, Stein invited Attorney General Jeff Jackson to provide an independent assessment.

“Since my time as Attorney General, I have been urging the General Assembly to give the Attorney General’s Office more authority to review hospital transactions,” Stein said in a statement. “Health care costs are too high, and additional oversight and authority would better protect patients.”

Wake County Attorney Roger Askew said the final deal agreement increases the indigent care WakeMed can provide from 4.8% in the initial offer to at least 8% of total adjusted revenues.