Wake commissioners may delay key vote on WakeMed, Atrium deal

A $2 billion plan to put WakeMed under Atrium Health control was facing a possible delay Monday as state leaders demanded more scrutiny and Wake County said its commissioners had taken no formal action on the deal. The pause matters because the vote was expected to help clear the way for a transaction that could reshape who controls one of the Triangle’s biggest health systems.

WakeMed and Charlotte-based Atrium Health announced the proposed combination Friday, and WakeMed’s board unanimously approved it this month, county records show. Under the plan, WakeMed would become affiliated with Advocate Health, Atrium’s parent nonprofit system, giving the Charlotte-based network a foothold in the fast-growing Raleigh market and WakeMed access to more capital, clinical trials and expansion resources.

The biggest questions now center on oversight and local control. State Treasurer Brad Briner said the attorney general and the Federal Trade Commission should review what the proposal could mean for North Carolinians, and later said he believed the vote would be delayed. State Auditor Dave Boliek also called Sunday for a delay to Monday’s planned vote, arguing the rollout raised transparency questions and deserved more scrutiny. Mike Schietzelt, the Republican who represents part of the area in the state House, said he had heard the vote would be delayed and warned the merger could significantly affect the cost and quality of care across Wake County.

For patients and employees, a delay would not change day-to-day care at WakeMed immediately, but it would keep the system in limbo while county and state officials sort through the terms. For county taxpayers, the hold means more time to press for answers about how much say Wake County would keep in a system that began as a public hospital and then went independent nearly three decades ago.

That history makes the proposal especially sensitive in Wake County. WakeMed was founded in 1961 as a county-owned hospital and became an independent, not-for-profit system in 1997. Its main campus started as Memorial Hospital of Wake County, and the system now operates multiple facilities in and around Raleigh, Wake Forest, Garner and Knightdale. WakeMed is the third-largest health care provider in the Triangle, making any change in ownership or affiliation a countywide issue, not just a hospital-board matter.

Atrium has said the combination could create 3,300 new health care jobs and bring nationally recognized specialty care closer to home, along with stronger mental health support and more convenient and affordable care. The deal comes as Wake County’s hospital market keeps tightening, with four health systems vying in 2024 to build or expand hospitals and more than $1 billion in proposed investment already on the table. A delay would not end the deal, but it would give Wake County leaders more time to decide whether the promised investment is worth the loss of local independence.